Individual provider Active NPI

Kerry L Baird, APNP

  • Family Nurse Practitioner
  • Shawano, WI
National Provider Identifier
1952932972
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9866 Issued in WI
Practice address
100 County Road B
Shawano, WI 54166-7072
Phone
(715) 524-2161
Fax
(715) 526-3461
NPI assigned
Jan 29, 2020
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 110635 WI
Family Nurse Practitioner 363LF0000X 9866 WI Primary

Addresses

Primary practice location

100 County Road B
Shawano, WI 54166-7072

Mailing address

122 E College Ave
Appleton, WI 54911-5741
Phone (920) 996-3264

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
I20200221001958 WI Practitioner - Nurse Practitioner 0749617231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 County Rd B
Shawano, WI 54166-7072
Phone (715) 526-2111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
110635WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Thedacare, Incorporated CurrentSince Feb 17, 2020 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Mar 1, 2020 Accepting new patients

Locations

122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

370 S Main St
Clintonville, WI 54929
Phone (715) 526-7370

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

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

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

Interoperability endpoints

  • Direct secure messaging: kbaird33273@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 8

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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1952932972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115741",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-524-2161",
            "fax_number": "715-526-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRD",
        "first_name": "KERRY",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "110635",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

Verify at the official NPI Registry.