Individual provider Active NPI

Youa Thao, NP

  • Primary Care Nurse Practitioner
  • Plover, WI
National Provider Identifier
1861953960
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F02190157 Issued in WI
Practice address
132 Devonshire CT Apt 2
Plover, WI 54467-4194
Phone
(262) 320-7790
NPI assigned
Mar 29, 2019
Last updated
Apr 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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 F02190157 WI Primary

Addresses

Primary practice location

132 Devonshire CT Apt 2
Plover, WI 54467-4194

Mailing address

132 Devonshire CT Apt 2
Plover, WI 54467-4194
Phone (262) 320-7790

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Health Information Exchange (HIE)

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
I20190906001807 WI Practitioner - Nurse Practitioner 7810226404 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F02190157WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Aug 26, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 26, 2019 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Aug 17, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 26, 2019 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1861953960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 DEVONSHIRE CT APT 2",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544674194",
            "telephone_number": "262-320-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 DEVONSHIRE CT APT 2",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544674194",
            "telephone_number": "262-320-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "YOUA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "F02190157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "132 Devonshire Ct Apt 2",
            "city": "Plover",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544674194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plover, WI

Sources for this page

Verify at the official NPI Registry.