Active NPI
Susan Pokorny, CERTIFIED DOULA
- Doula
- Port Washington, WI
National Provider Identifier
1003647975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- License
- 1470802
- Practice address
- 1042 S Spring St
Port Washington, WI 53074-2418 - Phone
- (262) 751-3463
- NPI assigned
- Aug 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | 1470802 | IL | |
| Doula | 374J00000X | 1470802 | WI | Primary |
Addresses
Primary practice location
1042 S Spring St
Port Washington, WI 53074-2418
Mailing address
3929 Windemere Dr
Colgate, WI 53017-9142
Phone (262) 751-3463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1470802 | IL | MD | Doula |
| 1470802 | WI | MD | Doula |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1003647975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3929 WINDEMERE DR",
"city": "COLGATE",
"state": "WI",
"postal_code": "530179142",
"telephone_number": "262-751-3463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1042 S SPRING ST",
"city": "PORT WASHINGTON",
"state": "WI",
"postal_code": "530742418",
"telephone_number": "262-751-3463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POKORNY",
"first_name": "SUSAN",
"credential": "CERTIFIED DOULA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-12",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "IL",
"license": "1470802",
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "WI",
"license": "1470802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.