Individual provider Active NPI

Marcie Ann Janz, APNP

  • Geriatric Medicine (Family Medicine) Physician
  • Fond Du Lac, WI
National Provider Identifier
1164415634
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
28 Issued in WI
Practice address
481 E Division St
Suite 100
Fond Du Lac, WI 54935-3748
Phone
(920) 929-8120
Fax
(920) 929-8126
NPI assigned
Aug 30, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28 WI
Geriatric Medicine (Family Medicine) Physician 207QG0300X 28 WI Primary

Addresses

Primary practice location

481 E Division St
Suite 100
Fond Du Lac, WI 54935-3748

Mailing address

481 E Division St
Suite 100
Fond Du Lac, WI 54935-3748
Phone (920) 929-8120

Other identifiers 1

IdentifierTypeStateIssuer
43817600MedicaidWI

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

LicenseStateTypeSpecialty
28WIMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Fond Du Lac LTD Past Accepting new patients
Dodge County Medical Facilities 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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164415634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 E DIVISION ST",
            "address_2": "SUITE 100",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353748",
            "telephone_number": "920-929-8120",
            "fax_number": "920-929-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 E DIVISION ST",
            "address_2": "SUITE 100",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353748",
            "telephone_number": "920-929-8120",
            "fax_number": "920-929-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANZ",
        "first_name": "MARCIE",
        "middle_name": "ANN",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "28",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "28",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43817600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.