Individual provider Active NPI

Annalyse Victoria Victor, MSN, APNP

  • Primary Care Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1932464468
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
6452-33 Issued in WI
Practice address
N16W24131 Riverwood Dr
Cancer Center
Waukesha, WI 53188-1106
Phone
(262) 930-0005
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X 17809930 WI
Family Nurse Practitioner 363LF0000X 6452 WI
Primary Care Nurse Practitioner 363LP2300X 6452-33 WI Primary

Addresses

Primary practice location

N16W24131 Riverwood Dr
Cancer Center
Waukesha, WI 53188-1106

Mailing address

W369S10410 Shearer Rd
Eagle, WI 53119-1719
Phone (262) 930-0005

Other names 1

  • Annalyse Victoria Kreger Former name

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
I20151030000045 WI Practitioner - Nurse Practitioner 7012227234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
17809930WIMDOncology Registered Nurse
6452WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Jul 1, 2020 Accepting new patients
Vpa PC CurrentSince Jul 1, 2020 Accepting new patients

Locations

13555 Bishops Ct
Ste 315
Brookfield, WI 53005
Phone (414) 255-0300

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1932464468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W369S10410 SHEARER RD",
            "city": "EAGLE",
            "state": "WI",
            "postal_code": "531191719",
            "telephone_number": "262-930-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N16W24131 RIVERWOOD DR",
            "address_2": "CANCER CENTER",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881106",
            "telephone_number": "262-930-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "ANNALYSE",
        "middle_name": "VICTORIA",
        "credential": "MSN, APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "WI",
            "license": "17809930",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6452",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "6452-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNALYSE",
            "last_name": "KREGER",
            "middle_name": "VICTORIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.