DANIEL D MEDLOCK APNP
NPI 1639439433
Nurse Practitioner - Psychiatric/Mental Health in Racine, WI

Q: What is Daniel Medlock's NPI number?

The NPI number for Daniel Medlock is 1639439433. It was assigned to this individual provider in the NPPES registry on May 25, 2012.

Q: What is Daniel Medlock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Daniel Medlock was last updated on January 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 25, 2012PECOS Enrolled

1320 WISCONSIN AVE, RACINE, WI 53403(262) 687-2956(262) 687-2014 Get Directions Write a Review

NPPES record last updated: January 24, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 24, 2022, Nov 22, 2019 (2 updates tracked since 2019).

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About Daniel D Medlock Apnp NPPES

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

DANIEL D MEDLOCK APNP (NPI 1639439433) is an individual psychiatric/mental health provider in Racine, Wisconsin, licensed in Wisconsin (9750) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639439433

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameDANIEL D MEDLOCKCredential: APNP

Location Address1320 WISCONSIN AVERacine, WI 53403-1978

Mailing Address1320 Wisconsin AveRacine, WI 53403-1978 · (262) 687-2956 · Fax (262) 687-2014

Phone(262) 687-2956

Fax(262) 687-2014

Sole ProprietorNo

Enumeration DateMay 25, 2012

Last NPPES UpdateJanuary 24, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 24, 2022

✔ NPI 1639439433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in WI · 9750

Also ListedNurse PractitionerTaxonomy 363L00000X · License 9750 (WI)

1320 WISCONSIN AVE, Racine, WI 53403

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Daniel D Medlock Apnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53403 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 20

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

KATHLEEN RASMUSSEN LPC

Counselor (Professional)