Active NPI
Mary Ann Reale, R.N.
- General Practice Registered Nurse
- Madison, WI
National Provider Identifier
1184648024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 64371-030
- Practice address
- 2500 Overlook Ter
Madison, WI 53705-2254 - Phone
- (608) 280-7061
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 64371-030 | WI | Primary |
Addresses
Primary practice location
2500 Overlook Ter
Madison, WI 53705-2254
Mailing address
2810 Van Hise Ave
Madison, WI 53705-3620
Phone (608) 238-7397
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64371-030 | WI | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184648024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2810 VAN HISE AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537053620",
"telephone_number": "608-238-7397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 OVERLOOK TER",
"city": "MADISON",
"state": "WI",
"postal_code": "537052254",
"telephone_number": "608-280-7061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REALE",
"first_name": "MARY ANN",
"name_prefix": "Ms.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "WI",
"license": "64371-030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.