Tanya Elmergreen, AGPCNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8001-33 Issued in WI

Practice address

1531 S Madison St
Appleton, WI 54915-1800

Phone

(920) 738-2000

NPI assigned

Nov 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment NPD
• Advanced Pain Management SC

  • Pain Medicine Physician
  • Greenfield, WI
  • NPI 1770506669
  NPD
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD
• Advanced Pain Management, SC

  • Durable Medical Equipment & Medical Supplies
  • Evansville, IN
  • NPI 1669832655
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1952814733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212059",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151800",
            "telephone_number": "920-738-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Division St",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544811843",
            "country_code": "US",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMERGREEN",
        "first_name": "TANYA",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8001-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "8001-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100073610",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100209146",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elles Nurturing Circle LLC
• Rachel Lee Elliott, DC
• Katie S Ellis, BCBA
• Michelle Ellis, M.D..
• Jonathan Elmer
• Brianna Jean Emanuel
• David John Emanuel, DDS
• Embrace Hope Counseling, LLC
• Embrace Wisconsin S.C.
• Emerald Valley Assisted Living, LLC

• Psychiatric/Mental Health Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.