Individual provider Active NPI

Amber Zubke, LPN

  • Licensed Practical Nurse
  • Watertown, WI
National Provider Identifier
1104378249
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
319238 Issued in WI
Practice address
1405 Oconomowoc Ave Apt 1
Watertown, WI 53094-5214
Phone
(262) 269-0152
NPI assigned
Oct 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 319238 WI Primary

Addresses

Primary practice location

1405 Oconomowoc Ave Apt 1
Watertown, WI 53094-5214

Mailing address

1405 Oconomowoc Ave Apt 1
Watertown, WI 53094-5214
Phone (262) 269-0152

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
319238WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1104378249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 OCONOMOWOC AVE APT 1",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530945214",
            "telephone_number": "262-269-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 OCONOMOWOC AVE APT 1",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530945214",
            "telephone_number": "262-269-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUBKE",
        "first_name": "AMBER",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "319238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.