Individual provider Active NPI

Molly T Condit, CRNA

  • Certified Registered Nurse Anesthetist
  • Green Bay, WI
National Provider Identifier
1922010784
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
138939 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 288-3388
Fax
(920) 288-3370
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 138939 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

2845 Greenbrier Rd
PO Box 8900
Green Bay, WI 54308-8900
Phone (920) 288-3388

Other identifiers 1

IdentifierTypeStateIssuer
44345400MedicaidWI

Other names 1

  • Molly T Hennig Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcondit14844@ewd.direct.hshs.ort Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000526 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618963406 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Bay Anesthesia Assoc. SCGroup PAC ID 4486613858, 70 clinicians

Practice addresses (Care Compare)

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111

Hospital & facility affiliations

  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097

Merit-based Incentive Payment System (MIPS)

Final score
74.22 of 100Reported as group
Quality
69.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
138939WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Green Bay Anesthesia Assoc. SC CurrentSince Sep 1, 2017 Accepting new patients
Nurse Anesthesia Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 11, 2012 Accepting new patients
Osms Anesthesia LLC CurrentSince Sep 15, 2024 Accepting new patients
Seven Hills Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Physicians Anesthesia Service Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026

1077 W Mason St
Green Bay, WI 54303
Phone (920) 497-1810

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

2223 Lime Kiln Rd
Ste 1
Green Bay, WI 54311
Phone (920) 468-0246

Bin 88263
Milwaukee, WI 53288

1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144

425 S Commercial St
Neenah, WI 54956
Phone (920) 725-0700

Organizations & group practices 5

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1922010784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "address_2": "PO BOX 8900",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543088900",
            "telephone_number": "920-288-3388",
            "fax_number": "920-288-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-3388",
            "fax_number": "920-288-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDIT",
        "first_name": "MOLLY",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "138939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44345400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcondit14844@ewd.direct.hshs.ort",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "835 S Van Buren St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543013526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "HENNIG",
            "middle_name": "T",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.