Individual provider Active NPI

Kristin A Neilsen, NP

  • Nurse Practitioner
  • Neenah, WI
National Provider Identifier
1902841497
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
347 Issued in WI
Practice address
333 N Green Bay Rd
Neenah, WI 54956-1954
Phone
(920) 727-6480
Fax
(920) 727-3490
NPI assigned
Jun 18, 2006
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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 347 WI Primary

Addresses

Primary practice location

333 N Green Bay Rd
Neenah, WI 54956-1954

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900

Other practice location 1

250 W 6th Ave
Oshkosh, WI 54902-5910
Phone (920) 237-5000

Other identifiers 1

IdentifierTypeStateIssuer
39901400MedicaidWI

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
I20061211000478 WI Practitioner - Nurse Practitioner 8628036050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1988
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
Certified Nurse Midwife, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Mar 1, 2011 Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients
Pine Ridge Indian Health Service Hospital Past Accepting new patients

Locations

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

2005 Midway Rd
Menasha, WI 54952
Phone (920) 380-4812

1380 Tullar Rd
Neenah, WI 54956
Phone (920) 205-0379

1504 S Commercial St
Neenah, WI 54956
Phone (920) 729-6088

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

333 N Green Bay Rd
Neenah, WI 54956
Phone (920) 725-2070

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

250 W 6th Ave
Oshkosh, WI 54902
Phone (920) 237-5000

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

Interoperability endpoints

  • Direct secure messaging: kneilsen13846@direct.thedacare.org

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1902841497",
    "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": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N GREEN BAY RD",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561954",
            "telephone_number": "920-727-6480",
            "fax_number": "920-727-3490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 W 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549025910",
            "country_code": "US",
            "telephone_number": "920-237-5000",
            "fax_number": "920-237-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEILSEN",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39901400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.