Individual provider Active NPI

Patricia Jean Vanburen, RN

  • General Practice Registered Nurse
  • Randolph, WI
National Provider Identifier
1295008662
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
178336-030 Issued in WI
Practice address
N6010 Jung Rd
Randolph, WI 53956-9706
Phone
(920) 326-5789
NPI assigned
Feb 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 178336-030 WI Primary

Addresses

Primary practice location

N6010 Jung Rd
Randolph, WI 53956-9706

Mailing address

N6010 Jung Road
Randolph, WI 53956
Phone (920) 326-5789

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

LicenseStateTypeSpecialty
178336-030WIMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1295008662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6010 JUNG ROAD",
            "city": "RANDOLPH",
            "state": "WI",
            "postal_code": "53956",
            "telephone_number": "920-326-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6010 JUNG RD",
            "city": "RANDOLPH",
            "state": "WI",
            "postal_code": "539569706",
            "telephone_number": "920-326-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBUREN",
        "first_name": "PATRICIA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WI",
            "license": "178336-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.