Individual provider Active NPI

Rebecca Lynn Buchholtz, APNP

  • Neonatal Nurse Practitioner
  • Wauwatosa, WI
National Provider Identifier
1215250717
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
3953-033 Issued in WI
Practice address
9000 W Wisconsin Ave
Wauwatosa, WI 53226-4874
Phone
(414) 266-4725
NPI assigned
Mar 11, 2010
Last updated
Sep 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 3953-033 WI Primary
Registered Nurse 163W00000X 154631-030 WI

Addresses

Primary practice location

9000 W Wisconsin Ave
Wauwatosa, WI 53226-4874

Mailing address

P.O. Box 1997
Ms 622 Children's Hospital of Wisconsin
Wauwatosa, WI 53201-1997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120925000788 WI Practitioner - Nurse Practitioner 1052560687 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3953WIMDGeneral Practice Dentistry
154631-030WIMDRegistered Nurse
3953-033WIMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Sep 25, 2012 Accepting new patients
Children's Specialty Group, Inc. Past Accepting new patients

Locations

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: rbuchholtz7866@direct.chw.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1215250717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1997",
            "address_2": "MS 622 CHILDREN'S HOSPITAL OF WISCONSIN",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532011997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHHOLTZ",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WI",
            "license": "3953-033",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "154631-030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.