Kerry L Baird, APNP
Individual provider Active NPI Family Nurse Practitioner · Shawano, WI
NPI 1952932972 · NPPES record last updated Feb 11, 2020
Key facts
- NPI
- 1952932972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9866 (WI)
- Practice address
- 100 County Road B
Shawano, WI 54166-7072 - Phone
- (715) 524-2161
- Fax
- (715) 526-3461
- NPI assigned
- Jan 29, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Thedacare Medical Center - Shawano, Inc.
Practice addresses (Care Compare)
100 County Rd B
Shawano, WI 54166-7072
Phone (715) 526-2111
Hospital & facility affiliations
- Thedacare Medical Center - Shawano
- Thedacare Regional Med Ctr - Neenah
- Thedacare Medical Center - New London
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200221001958 | WI | Practitioner - Nurse Practitioner | 0749617231 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110635 | WI | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Current |
Accepting new patients | |
| Thedacare Medical Center - Shawano, Inc. | Current |
Accepting new patients | |
| Thedacare Medical Center - Shawano, Inc. | Current |
Accepting new patients | |
| Thedacare Medical Center - Berlin, Inc. | Past | Accepting new patients |
Locations
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264
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
- kbaird33273@direct.thedacare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 110635 | WI | |
| Family Nurse Practitioner | 363LF0000X | 9866 | WI | Yes |
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
Other providers in Shawano, WI
- Appleton Audiology Associates, LLC
- Jeannette Theresa Arias-Flynn
- Ashley Walsh and Associates, LLC
- Aurora Medical Group, Inc.
- Amanda E Baddmoccosin-Barnes
- Heather Lynn Bannister
- Katie Jane Bartell
- Elizabeth A Bartz
- Sarah Bauer
- Baycare Clinic LLP
All providers in Shawano, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.