Active NPI
Andrea Maria Dosedla
- Prevention Professional
- Sussex, WI
National Provider Identifier
1326679663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 1682-39
- Practice address
- N61W23044 Harrys Way
Sussex, WI 53089-3995 - Phone
- (414) 566-7627
- NPI assigned
- Jan 27, 2020
- 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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 1682-39 | WI | Primary |
Addresses
Primary practice location
N61W23044 Harrys Way
Sussex, WI 53089-3995
Mailing address
1141 S 75TH St
West Allis, WI 53214-3020
Phone (262) 210-7127
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 |
|---|---|---|---|
| 1682-39 | WI | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1326679663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 S 75TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532143020",
"telephone_number": "262-210-7127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N61W23044 HARRYS WAY",
"city": "SUSSEX",
"state": "WI",
"postal_code": "530893995",
"telephone_number": "414-566-7627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOSEDLA",
"first_name": "ANDREA",
"middle_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-27",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "WI",
"license": "1682-39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sussex, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.