Active NPI
Gladys Shan Reese, R.N.
- Registered Nurse
- Rhinelander, WI
National Provider Identifier
1235466038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 83990-030
- Practice address
- 6066 Wildwood Lake Cir
Rhinelander, WI 54501-9793 - Phone
- (715) 369-0311
- NPI assigned
- Nov 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 83990-030 | WI | Primary |
Addresses
Primary practice location
6066 Wildwood Lake Cir
Rhinelander, WI 54501-9793
Mailing address
6066 Wildwood Lake Cir
Rhinelander, WI 54501-9793
Phone (715) 369-0311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38325806 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 83990-030 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258329600000",
"number": "1235466038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6066 WILDWOOD LAKE CIR",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545019793",
"telephone_number": "715-369-0311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6066 WILDWOOD LAKE CIR",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545019793",
"telephone_number": "715-369-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "GLADYS",
"middle_name": "SHAN",
"name_prefix": "Mrs.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-16",
"last_updated": "2009-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "83990-030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38325806",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rhinelander, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.