Mitchell Whalen
Individual provider Active NPI Family Nurse Practitioner · Darlington, WI
NPI 1992486336 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1992486336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 14287-33 (WI)
- Practice address
- 731 Clay St
Darlington, WI 53530-1225 - Phone
- (608) 776-4497
- NPI assigned
- Jul 27, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lafayette County
Practice addresses (Care Compare)
211 Bev Anderson Dr
Darlington, WI 53530-8801
Phone (608) 776-4466
Hospital & facility affiliations
- Lafayette Hospital and Clinics
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 |
|---|---|---|---|---|
| I20230816003192 | WI | Practitioner - Nurse Practitioner | 7618339078 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 235849-30 | WI | MD | Registered Nurse |
| 14287-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lafayette County | Current |
Accepting new patients | |
| The Monroe Clinic, Inc. | Current |
Accepting new patients | |
| The Monroe Clinic, Inc. | Current |
Accepting new patients | |
| Lafayette County | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Lafayette County | Current | Accepting new patients | |
| Lafayette County | Past | Accepting new patients |
Locations
211 Bev Anderson Dr
Darlington, WI 53530
Phone (608) 776-4466
15701 County Road K
Ste 3
Darlington, WI 53530
Phone (608) 776-4800
731 Clay St
Darlington, WI 53530
Phone (608) 776-4497
800 Clay St
Darlington, WI 53530
Phone (608) 776-4466
2009 5th St
Monroe, WI 53566
Phone (608) 324-1454
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
104 S Judgement St
Shullsburg, WI 53586
Phone (608) 965-4475
Interoperability endpoints
- mwhalen998723@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 235849-30 | WI | |
| Family Nurse Practitioner | 363LF0000X | 14287-33 | WI | Yes |
Addresses
Primary practice location
731 Clay St
Darlington, WI 53530-1225
Mailing address
800 Clay St
Darlington, WI 53530-1228
Other providers in Darlington, WI
- Amy Thompson
- Amy L. Tibbits
- Gregory Jacob Tulachka
- Darci Ann Weber
- Kailee M Whalen
- Michael A White
- Whitford Pharmacy
- Daisy Wiegel
- Bradley R Willborn
- Melanie Willborn
All providers in Darlington, 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 Jul 27, 2023. 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.