Individual provider Active NPI

Kay A Weina, CNM

  • Advanced Practice Midwife
  • Neenah, WI
National Provider Identifier
1922118082
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
107765 Issued in WI
Practice address
200 Theda Clark Medical PLZ
Suite 130
Neenah, WI 54956-2721
Phone
(920) 729-7105
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2497-33 WI
Advanced Practice Midwife 367A00000X 107765 WI Primary

Addresses

Primary practice location

200 Theda Clark Medical PLZ
Suite 130
Neenah, WI 54956-2721

Mailing address

3232 N Ballard Rd Ste 100
Appleton, WI 54911-8804
Phone (920) 729-7105

Other identifiers 1

IdentifierTypeStateIssuer
41192200MedicaidWI

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040910001261 WI Practitioner - Certified Nurse Midwife (CNM) 2466429303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care of Wisconsin SCGroup PAC ID 3072416601, 23 clinicians

Practice addresses (Care Compare)

200 Theda Clark Medical PLZ
Suite 130
Neenah, WI 54956-2790
Phone (920) 729-7105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2497-33WIMDNurse Practitioner
107765WIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care of Wisconsin S.C. CurrentSince Apr 1, 2014 Accepting new patients
Theda Clark OB Hospitalists SC CurrentSince Sep 5, 2023 Accepting new patients

Locations

3913 W Prospect Ave
Ste LL1
Appleton, WI 54914

3232 N Ballard Rd
Ste 100
Appleton, WI 54911

200 Theda Clark Medical Plz
Ste 130
Neenah, WI 54956

491 S Washburn St
Oshkosh, WI 54904
Phone (920) 292-1555

Interoperability endpoints

  • Direct secure messaging: kweina68785@direct.thedacare.org

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1922118082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD STE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-729-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ",
            "address_2": "SUITE 130",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562721",
            "telephone_number": "920-729-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINA",
        "first_name": "KAY",
        "middle_name": "A",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2497-33",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WI",
            "license": "107765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41192200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.