Individual provider Active NPI

Mark Henry Doornek, RN-BSN

  • Registered Nurse
  • Greenfield, WI
National Provider Identifier
1053240721
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
176075-30 Issued in WI
Practice address
4800 S 60TH St
Greenfield, WI 53220-4616
Phone
(414) 855-2439
Fax
(414) 255-8902
NPI assigned
May 18, 2026
Last updated
May 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 176075-30 WI Primary

Addresses

Primary practice location

4800 S 60TH St
Greenfield, WI 53220-4616

Mailing address

3823 S 95TH St
Milwaukee, WI 53228-1436
Phone (414) 855-2439

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

LicenseStateTypeSpecialty
176075-30WIMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1053240721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 S 95TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532281436",
            "telephone_number": "414-855-2439",
            "fax_number": "414-255-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S 60TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204616",
            "telephone_number": "414-855-2439",
            "fax_number": "414-255-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOORNEK",
        "first_name": "MARK",
        "middle_name": "HENRY",
        "credential": "RN-BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "176075-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.