Active NPI
Julie Ann Averbeck, NP
- Pediatric Nurse Practitioner
- New Berlin, WI
National Provider Identifier
1063466191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 86080-030
- Practice address
- 4855 S Moorland Rd
Suite 150
New Berlin, WI 53151-7494 - Phone
- (414) 425-5660
- Fax
- (414) 425-9803
- NPI assigned
- May 22, 2006
- Last updated
- Mar 1, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 86080-030 | WI | Primary |
Addresses
Primary practice location
4855 S Moorland Rd
Suite 150
New Berlin, WI 53151-7494
Mailing address
4855 S Moorland Rd
Suite 150
New Berlin, WI 53151-7494
Phone (414) 425-5660
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43950200 | Medicaid | WI | |
| 009006261A | Other | HUMANA |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86080-030 | WI | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Medical Group | Past | Accepting new patients | |
| Children's Medical Group | Past | Accepting new patients |
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.
-
dba MBH Telehealth
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1205068616
-
dba Forest View Pediatrics
- Pediatrics Physician
- New Berlin, WI
- NPI 1427223767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1063466191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4855 S MOORLAND RD",
"address_2": "SUITE 150",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517494",
"telephone_number": "414-425-5660",
"fax_number": "414-425-9803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 S MOORLAND RD",
"address_2": "SUITE 150",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517494",
"telephone_number": "414-425-5660",
"fax_number": "414-425-9803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERBECK",
"first_name": "JULIE ANN",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-22",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WI",
"license": "86080-030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43950200",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "009006261A",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.