Individual provider Active NPI

Brenda N Reisdorph, RN

  • Gerontology Nurse Practitioner
  • Reedsburg, WI
National Provider Identifier
1851392864
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
82979 Issued in WI
Practice address
2000 N Dewey Ave
Reedsburg, WI 53959-1049
Phone
(608) 524-6487
Fax
(608) 524-0842
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 82979 WI Primary

Addresses

Primary practice location

2000 N Dewey Ave
Reedsburg, WI 53959-1049

Mailing address

2000 N Dewey Ave
Reedsburg, WI 53959-1049
Phone (608) 524-6487

Other identifiers 1

IdentifierTypeStateIssuer
43970300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060926000501 WI Practitioner - Nurse Practitioner 4385649300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland HospitalGroup PAC ID 7618861618, 69 clinicians

Practice addresses (Care Compare)

333 E 2ND St
Richland Center, WI 53581-1900

Hospital & facility affiliations

  • Richland Hospital Hospital, Richland Center, WI, CCN 521341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
82979WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reedsburg Area Medical Center Inc CurrentSince Sep 15, 2013 Accepting new patients
Richland Hospital CurrentSince Dec 22, 2019 Accepting new patients
Richland Hospital CurrentSince Dec 22, 2019 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Sep 15, 2013 Accepting new patients

Locations

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

301 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1851392864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N DEWEY AVE",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591049",
            "telephone_number": "608-524-6487",
            "fax_number": "608-524-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N DEWEY AVE",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591049",
            "telephone_number": "608-524-6487",
            "fax_number": "608-524-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISDORPH",
        "first_name": "BRENDA",
        "middle_name": "N",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "82979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43970300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsburg, WI

Sources for this page

Verify at the official NPI Registry.