Active NPI
Diane L Sippel, NP
- Nurse Practitioner
- Verona, WI
National Provider Identifier
1053393769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1721
- Practice address
- 333 Prairie Oaks Dr
Verona, WI 53593-2005 - Phone
- (920) 579-1063
- NPI assigned
- Nov 17, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 1721 | WI | |
| Nurse Practitioner | 363L00000X | 1721 | WI | Primary |
Addresses
Primary practice location
333 Prairie Oaks Dr
Verona, WI 53593-2005
Mailing address
333 Prairie Oaks Dr
Verona, WI 53593-2005
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13106 | Other | WI | DEAN |
| 39080723697 | Other | WI | UNITY |
| 43939000 | Medicaid | WI | |
| 500017150 | Other | WI | RAILROAD MEDICARE |
| WI01L7 | Other | WI | JOHN DEERE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1721 | WI | MD | Critical Care Medicine (Internal Medicine) Physician |
Interoperability endpoints
- jschulte1135046@direct.uwhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1053393769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 PRAIRIE OAKS DR",
"city": "VERONA",
"state": "WI",
"postal_code": "535932005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 PRAIRIE OAKS DR",
"city": "VERONA",
"state": "WI",
"postal_code": "535932005",
"telephone_number": "920-579-1063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIPPEL",
"first_name": "DIANE",
"middle_name": "L",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-17",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WI",
"license": "1721",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "1721",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN",
"identifier": "13106",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITY",
"identifier": "39080723697",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43939000",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500017150",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "WI01L7",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Verona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.