Jeanie Faught, RN, NP, PTA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

29227 Issued in NM

Practice address

835 Potts Ave
Green Bay, WI 54304-4535

Phone

(920) 491-9079

Fax

(920) 491-9082

NPI assigned

Jun 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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

• Healthcare Clinic and Wellness Center

  • Health Maintenance Organization
  • Green Bay, WI
  • NPI 1942465430
  NPD (past)

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1225299704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 POTTS AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044535",
            "telephone_number": "920-491-9079",
            "fax_number": "920-491-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 POTTS AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044535",
            "telephone_number": "920-491-9079",
            "fax_number": "920-491-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUGHT",
        "first_name": "JEANIE",
        "credential": "RN, NP, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "29227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund S. Fangman, M.D.
• Dan A Farah, DC
• Thomas M. Farley, M.D.
• Julie Anne Farrell, DDS
• Taresa B Fassbender, PA
• Tracy Jenifer Faust, M.A., LPC, SAC, NCC
• Kayla Joanne Fausti, LPC, SAC
• Fay Dental Care LLC
• John Michael Fay II, DDS
• Bradley Jay Fedderly, MD

• Registered Nurse in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.