Nasra Mohamed Warsame, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

53927-20 Issued in WI

Practice address

11051 N Sherman Rd
Edgerton, WI 53534-9002

Phone

(608) 884-3354

Fax

(608) 884-5022

NPI assigned

Apr 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1154595239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11051 N SHERMAN RD",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535349002",
            "telephone_number": "608-884-3354",
            "fax_number": "608-884-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11051 N SHERMAN RD",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535349002",
            "telephone_number": "608-884-3354",
            "fax_number": "608-884-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARSAME",
        "first_name": "NASRA",
        "middle_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "53927-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH SYSTEMS",
            "identifier": "61161",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100017474",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas H Reitz DDS SC
• Kevin C Trampe, PHARMD
• True Health and Performance LLC
• Tonya Jo Vike, RN
• Daphne Wang, SPEECH PATHOLOGIST
• Jedd P Wellenkotter, DPT
• Kristen Wellenkotter, DPT
• Tyler William Wendt, DPT
• Lance Edward Wiese, RPH
• Wil Hospitalists LLC

• All providers in Edgerton, WI
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.