Active NPI
Millicent Joanna Doud, NURSE PRACTITIONER
- Nurse Practitioner
- Lake Geneva, WI
National Provider Identifier
1285135467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 8165
- Practice address
- Lake Geneva 146 E Geneva Square
Lake Geneva, WI 53157 - Phone
- (262) 422-8038
- NPI assigned
- Feb 23, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 8165 | WI | Primary |
Addresses
Primary practice location
Lake Geneva 146 E Geneva Square
Lake Geneva, WI 53157
Mailing address
W309S10910 County Hwy I
Mukwonago, WI 53149
Phone (262) 422-8038
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100075486 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mdoud197716@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8165 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1285135467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W309S10910 COUNTY HWY I",
"city": "MUKWONAGO",
"state": "WI",
"postal_code": "53149",
"telephone_number": "262-422-8038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LAKE GENEVA 146 E GENEVA SQUARE",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "53157",
"telephone_number": "262-422-8038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUD",
"first_name": "MILLICENT",
"middle_name": "JOANNA",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-23",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "8165",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100075486",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mdoud197716@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "Lake Geneva 146 E Geneva Square",
"city": "Lake Geneva",
"state": "WI",
"country_code": "US",
"postal_code": "53157",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "Lake Geneva 146 E Geneva Square",
"city": "Lake Geneva",
"state": "WI",
"country_code": "US",
"postal_code": "53157",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lake Geneva, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.