Individual provider Active NPI

Naomi E Minks

  • Family Nurse Practitioner
  • Phillips, WI
National Provider Identifier
1265749857
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4158-33 Issued in WI
Practice address
625 Peterson Ave
Phillips, WI 54555-1452
Phone
(715) 339-4035
Fax
(715) 339-4036
NPI assigned
Sep 3, 2010
Last updated
May 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4158-33 WI Primary

Addresses

Primary practice location

625 Peterson Ave
Phillips, WI 54555-1452

Mailing address

143 South Gibson Street
Medford, WI 54451-1622
Phone (715) 748-2121

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4158-33WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1265749857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SOUTH GIBSON STREET",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PETERSON AVE",
            "city": "PHILLIPS",
            "state": "WI",
            "postal_code": "545551452",
            "telephone_number": "715-339-4035",
            "fax_number": "715-339-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKS",
        "first_name": "NAOMI",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4158-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillips, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.