Individual provider Active NPI

Deborah L Roe, APNP

  • Adult Health Nurse Practitioner
  • Fort Atkinson, WI
National Provider Identifier
1053590851
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3268-33 Issued in WI
Practice address
611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone
(920) 568-6090
NPI assigned
Oct 29, 2007
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3268-33 WI Primary

Addresses

Primary practice location

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

Mailing address

PO Box 249
Fort Atkinson, WI 53538-0249
Phone (920) 568-5000

Other practice location 1

1520 Madison Ave
Fort Atkinson, WI 53538-3100
Phone (920) 563-5500

Other practice location 2

1461 W Main St
Whitewater, WI 53190-1568
Phone (262) 473-5888

Other practice location 3

500 McMillen St
Fort Atkinson, WI 53538-1233
Phone (920) 563-5571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000197 WI Practitioner - Nurse Practitioner 7012005184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Healthcare IncGroup PAC ID 0840189718, 159 clinicians

Practice addresses (Care Compare)

611 E Sherman Ave
Fort Atkinson, WI 53538-1960
Phone (920) 568-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3268-33WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Healthcare Inc CurrentSince Aug 15, 2011 Accepting new patients
Fort Healthcare Inc Current Accepting new patients

Locations

1520 Madison Ave
Fort Atkinson, WI 53538
Phone (920) 563-5500

500 McMillen St
Fort Atkinson, WI 53538
Phone (920) 563-5571

512 Wilcox St
Fort Atkinson, WI 53538
Phone (920) 563-7366

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1461 W Main St
Whitewater, WI 53190
Phone (262) 472-6839

Interoperability endpoints

  • Direct secure messaging: deborah.roe@direct.forthc.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1053590851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535380249",
            "telephone_number": "920-568-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381960",
            "telephone_number": "920-568-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Atkinson",
            "state": "WI",
            "postal_code": "535383100",
            "country_code": "US",
            "telephone_number": "920-563-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1461 W Main St",
            "address_purpose": "LOCATION",
            "city": "Whitewater",
            "state": "WI",
            "postal_code": "531901568",
            "country_code": "US",
            "telephone_number": "262-473-5888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 McMillen St",
            "address_purpose": "LOCATION",
            "city": "Fort Atkinson",
            "state": "WI",
            "postal_code": "535381233",
            "country_code": "US",
            "telephone_number": "920-563-5571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROE",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "3268-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

Verify at the official NPI Registry.