Active NPI
Monica Basehore, PH.D., FACMG
- Clinical Molecular Genetics Physician
- Fitchburg, WI
National Provider Identifier
1194306142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Molecular Genetics Physician
- License
- 2007013
- Practice address
- 5445 E Cheryl Pkwy
Fitchburg, WI 53711-5373 - Phone
- (608) 210-5977
- NPI assigned
- Apr 20, 2021
- 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 |
|---|---|---|---|---|
| Clinical Molecular Genetics Physician | 207SG0203X | 2007013 | NC | Primary |
Addresses
Primary practice location
5445 E Cheryl Pkwy
Fitchburg, WI 53711-5373
Mailing address
2800 Woods Hollow Rd
Fitchburg, WI 53711-5399
Phone (608) 210-5977
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007013 | NC | MD | Clinical Molecular Genetics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1194306142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 WOODS HOLLOW RD",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537115399",
"telephone_number": "608-210-5977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5445 E CHERYL PKWY",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537115373",
"telephone_number": "608-210-5977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASEHORE",
"first_name": "MONICA",
"name_prefix": "Dr.",
"credential": "PH.D., FACMG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0203X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Molecular Genetics",
"state": "NC",
"license": "2007013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fitchburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.