Active NPI
Robyn Nothem
- Nurse Practitioner
- Grafton, WI
National Provider Identifier
1306382759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 7454
- Practice address
- 215 Washington St
Grafton, WI 53024-1700 - Phone
- (262) 375-3700
- Fax
- (262) 376-6024
- NPI assigned
- Jan 10, 2017
- 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 | 7454 | WI | Primary |
Addresses
Primary practice location
215 Washington St
Grafton, WI 53024-1700
Mailing address
2801 W Kinnickinnic River Pkwy
Suite 630
Milwaukee, WI 53215-3669
Phone (414) 649-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306382759 | 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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7454 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1306382759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 W KINNICKINNIC RIVER PKWY",
"address_2": "SUITE 630",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153669",
"telephone_number": "414-649-6000",
"fax_number": "414-385-2408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 WASHINGTON ST",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530241700",
"telephone_number": "262-375-3700",
"fax_number": "262-376-6024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOTHEM",
"first_name": "ROBYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-10",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "7454",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306382759",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.