Karissa A Glass · Nurse Practitioner

2845 Greenbrier Rd, Green Bay, WI 54311-6519

Overview

Karissa A Glass is a Nurse Practitioner practicing in Green Bay, Wisconsin. The National Provider Identifier (NPI) is #1770306912, which was assigned on November 6, 2024, and the registration record was last updated on May 15, 2025. The practitioner's main practice location is at 2845 Greenbrier Rd, Green Bay, WI 54311-6519; the contact telephone number is 9202888000. The primary taxonomy of Karissa A Glass is Nurse Practitioner (363L00000X). Karissa A Glass is licensed to practice in the state of Wisconsin (#51815).

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Provider Information

NPI 1770306912
Entity Type Individual
Provider Name KARISSA A GLASS
Gender Female
Credential RN
Practice Address 2845 Greenbrier Rd
Green Bay
WI 54311-6519
Practice Telephone 9202888000
Mailing Address Po Box 735044
Chicago
IL 60673-5044
Mailing Telephone 8003262250
Certification Date 2025-05-15
Enumeration Date 2024-11-06
Last Update Date 2025-05-15
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 0446770895
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name KARISSA A GLASS
Primary Specialty NURSE PRACTITIONER
Organization Legal Name AURORA MEDICAL GROUP, INC.
Address 2845 Greenbrier Rd
Green Bay
WI 54311-6519

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y363L00000XNurse Practitioner51815WI

Other Provider Identifiers

Other IdentifierIssuing StateIssuerIdentifier Type
100308400WIMEDICAID

Taxonomy Information

Primary Taxonomy

Code 363L00000X
Taxonomy Nurse Practitioner
Classification Nurse Practitioner
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses' Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

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Location Information

Street Address 2845 GREENBRIER RD
City GREEN BAY
State WI
Zip Code 54311-6519
Country US

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Provider NameAddressTaxonomyEnumeration Date
Kelly Lauretta Retzlaff 2845 Greenbrier Rd, Green Bay, WI 54311-6519Audiologist2021-09-28
Nicholas Gibson 2845 Greenbrier Rd, Green Bay, WI 54311-6519Internal Medicine Physician2022-04-05
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.