Individual provider Active NPI

Christie S. Henke, NP

  • Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1871835330
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5254 Issued in WI
Practice address
3925 N Gateway Dr
Appleton, WI 54913-7863
Phone
(920) 702-6371
NPI assigned
Mar 22, 2013
Last updated
May 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5254 WI Primary

Addresses

Primary practice location

3925 N Gateway Dr
Appleton, WI 54913-7863

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 702-6371

Other practice location 1

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130514000201 WI Practitioner - Nurse Practitioner 3577700475 Reassigns benefits to 3 organizations
I20220124000677 IA Practitioner - Nurse Practitioner 3577700475

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (920) 454-8401

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5254WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Apr 20, 2024 Accepting new patients
Pivotal Health, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Sequoia Integrative Medical Services LLC CurrentSince Apr 28, 2021 Accepting new patients

Locations

770 Tanglefoot Ln
Bettendorf, IA 52722
Phone (563) 241-7443

3925 N Gateway Dr
Appleton, WI 54913
Phone (920) 702-6371

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

1351 Ontario Rd
Green Bay, WI 54311
Phone (920) 328-1220

3030 Laura Ln
Ste 130
Middleton, WI 53562
Phone (888) 688-4746

3169 Deming Way
Middleton, WI 53562
Phone (608) 716-8286

3169 Deming Way
Ste A
Middleton, WI 53562

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

2755 Algoma Blvd
Oshkosh, WI 54901
Phone (888) 688-4746

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: chenke339745@direct.thedacare.org
  • FHIR API: https://api.platform.athenahealth.com/23915/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1871835330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-702-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N GATEWAY DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137863",
            "telephone_number": "920-702-6371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549047668",
            "country_code": "US",
            "telephone_number": "920-303-8700",
            "fax_number": "920-303-8831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENKE",
        "first_name": "CHRISTIE",
        "middle_name": "S.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.