Individual provider Active NPI

Alexa Renee Wichmann, RN

  • Medical-Surgical Clinical Nurse Specialist
  • Iowa City, IA
National Provider Identifier
1205420486
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X
License
162585 Issued in IA
Practice address
601 Highway 6 W
Iowa City, IA 52246-2209
Phone
(319) 338-0581
NPI assigned
Feb 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Clinical Nurse Specialist 364SM0705X 162585 IA Primary

Addresses

Primary practice location

601 Highway 6 W
Iowa City, IA 52246-2209

Mailing address

601 Highway 6 W
Iowa City, IA 52246-2209
Phone (319) 338-0581

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL unknown

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
162585IAMDMedical-Surgical Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1205420486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462209",
            "telephone_number": "319-338-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462209",
            "telephone_number": "319-338-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "ALEXA",
        "middle_name": "RENEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "IA",
            "license": "162585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "address_1": "601 Highway 6 W",
            "city": "Iowa City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "522462209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.