Active NPI
Andrew Gorsuch
- Psychiatric/Mental Health Registered Nurse
- Baraboo, WI
National Provider Identifier
1245496066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 120816-030
- Practice address
- 505 Broadway St
Baraboo, WI 53913-2183 - Phone
- (605) 355-4200
- NPI assigned
- Jul 31, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 120816-030 | WI | Primary |
Addresses
Primary practice location
505 Broadway St
Baraboo, WI 53913-2183
Mailing address
505 Broadway St
PO Box 29
Baraboo, WI 53913-2183
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120816-030 | WI | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1245496066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 BROADWAY ST",
"address_2": "PO BOX 29",
"city": "BARABOO",
"state": "WI",
"postal_code": "539132183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 BROADWAY ST",
"city": "BARABOO",
"state": "WI",
"postal_code": "539132183",
"telephone_number": "605-355-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORSUCH",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "WI",
"license": "120816-030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.