Mary K Gatzke, DNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2426-33 Issued in WI

Practice address

W5726 County T
Watertown, WI 53094-9140

Phone

(920) 253-6582

NPI assigned

Sep 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1205823630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5726 COUNTY T",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530949140",
            "telephone_number": "920-253-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5726 COUNTY T",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530949140",
            "telephone_number": "920-253-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATZKE",
        "first_name": "MARY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2426033",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704241650",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "2426-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR - MEDICARE",
            "identifier": "P00124270",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "N97840001",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43999100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah J Fredrich, LCSW
• Edward Fairfax Frost, MD
• Jeffrey Fruendt, D.C.
• Jennifer Wynne Furlong, APNP
• Jennifer Garcia, OTR/L
• Jade Gauthier, PTA
• Harry E Gibson, DDS
• Lynn Marie Gilbert, RN/RCS
• Nadine May Gilbert, LCSW
• Cary J Gillingham, D.D.S.

• Gerontology Nurse Practitioner in Watertown, WI
• Providers in Watertown, WI by specialty
• Gerontology Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.