Individual provider Active NPI

Christine Marie Horneck, RN, RCS

  • General Practice Registered Nurse
  • Plymouth, WI
National Provider Identifier
1376713842
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
Practice address
911 Fairview Dr
Apt. 4
Plymouth, WI 53073-1335
Phone
(920) 449-5258
NPI assigned
Mar 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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 WI Primary

Addresses

Primary practice location

911 Fairview Dr
Apt. 4
Plymouth, WI 53073-1335

Mailing address

911 Fairview Dr
Apt. 4
Plymouth, WI 53073-1335
Phone (920) 449-5258

Other identifiers 1

IdentifierTypeStateIssuer
35052400MedicaidWI

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
118700-030WIMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1376713842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 FAIRVIEW DR",
            "address_2": "APT. 4",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530731335",
            "telephone_number": "920-449-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 FAIRVIEW DR",
            "address_2": "APT. 4",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530731335",
            "telephone_number": "920-449-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNECK",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RN, RCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35052400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.