TAYLOR RAE ROTHERHAM-DECREMER NP
NPI 1427689074
Nurse Practitioner in Green Bay, WI

Q: What is Taylor Rotherham-decremer's NPI number?

The NPI number for Taylor Rotherham-decremer is 1427689074. It was assigned to this individual provider in the NPPES registry on February 3, 2020.

Q: What is Taylor Rotherham-decremer's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since February 03, 2020PECOS Enrolled

1920 LIBAL ST, GREEN BAY, WI 54301(920) 436-8691 Get Directions Write a Review

NPPES record last updated: December 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 8, 2022, Nov 20, 2020, Feb 3, 2020 (3 updates tracked since 2020).

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About Taylor Rae Rotherham-decremer Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAYLOR RAE ROTHERHAM-DECREMER NP (NPI 1427689074) is an individual nurse practitioner in Green Bay, Wisconsin, licensed in Wisconsin (9464-33) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and maintains 6 additional practice locations.

NPPES Registry Identity

NPI1427689074

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameTAYLOR RAE ROTHERHAM-DECREMERCredential: NP

Location Address1920 LIBAL STGreen Bay, WI 54301-2471

Mailing AddressPo Box 22487Green Bay, WI 54305-2487 · (920) 445-7210 · Fax (920) 445-7289

Phone(920) 436-8691

Sole ProprietorNo

Enumeration DateFebruary 3, 2020

Last NPPES UpdateDecember 8, 20223 updates tracked since enumeration

NPPES CertifiedDecember 8, 2022

✔ NPI 1427689074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 9464-33

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.

1920 LIBAL ST, Green Bay, WI 54301

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Secondary Practice Locations 6

Location 1723 S Wisconsin StPulaski, WI 54162-9303 · Phone (920) 822-1100 · Fax (920) 822-5731

Location 21630 Commanche AveGreen Bay, WI 54313-5753 · Phone (920) 430-4700 · Fax (920) 430-4747

Location 31976 Lime Kiln RdGreen Bay, WI 54311-4417 · Phone (920) 445-7377 · Fax (920) 592-9479

Location 42015 Shawano AveGreen Bay, WI 54303-2606 · Phone (920) 592-9478

Location 53415 Custer StManitowoc, WI 54220-4324 · Phone (920) 652-9310 · Fax (920) 652-9316

Location 63263 Eaton RdGreen Bay, WI 54311-6830 · Phone (920) 433-6000 · Fax (920) 433-6009

Other Identifiers 1

OtherF07191161American Academy Of Nurse Practitioners

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Taylor Rae Rotherham-decremer Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Taylor Rotherham-decremer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bellin Memorial Hospital Inc

1.1 mi

Otolaryngology

923 ELIZA ST
Green Bay, WI 54301

Reassigned Medicare billing, Wisconsin enrollment
875 clinicians in this Medicare group

NPI 1932565272 (920) 965-4800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TONY JAMES BUSSE PT

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