Individual provider Active NPI

Grace Knabel, APNP

  • Primary Care Nurse Practitioner
  • Wauwatosa, WI
National Provider Identifier
1861262511
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
14622 Issued in WI
Practice address
201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone
(414) 874-4555
NPI assigned
Jan 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 14622 WI Primary

Addresses

Primary practice location

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

Mailing address

16635 Burleigh PL
Brookfield, WI 53005-2770
Phone (262) 894-8024

Other practice location 1

19333 W North Ave
Brookfield, WI 53045-4198
Phone (262) 785-2000

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
I20240219001926 WI Practitioner - Nurse Practitioner 5294179131 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14622WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Feb 5, 2024 Accepting new patients
St. Luke'S Health Services, Inc. PastSince Feb 5, 2024 Accepting new patients

Locations

19475 W North Ave
Ste 305
Brookfield, WI 53045
Phone (262) 780-4070

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

201 N Mayfair Rd
Fl 3
Wauwatosa, WI 53226
Phone (414) 259-7480

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1861262511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16635 BURLEIGH PL",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052770",
            "telephone_number": "262-894-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-874-4555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19333 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530454198",
            "country_code": "US",
            "telephone_number": "262-785-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNABEL",
        "first_name": "GRACE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "14622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.