Individual provider Active NPI

Joanne S Dustrude, RN

  • Home Health Registered Nurse
  • New Berlin, WI
National Provider Identifier
1194953711
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
88101 Issued in WI
Practice address
4951 S Jonathan LN
New Berlin, WI 53151-7618
Phone
(414) 425-2566
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 88101 WI Primary

Addresses

Primary practice location

4951 S Jonathan LN
New Berlin, WI 53151-7618

Mailing address

4951 S Jonathan LN
New Berlin, WI 53151-7618
Phone (414) 425-2566

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

LicenseStateTypeSpecialty
88101WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1194953711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 S JONATHAN LN",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517618",
            "telephone_number": "414-425-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 S JONATHAN LN",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517618",
            "telephone_number": "414-425-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSTRUDE",
        "first_name": "JOANNE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "88101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.