Individual provider Active NPI

Bobbiejo Paul, APNP

  • Family Nurse Practitioner
  • Pewaukee, WI
National Provider Identifier
1376966580
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5651-33 Issued in WI
Practice address
2835 N Grandview Blvd
Suite 100
Pewaukee, WI 53072-5546
Phone
(262) 574-2711
Fax
(262) 574-5193
NPI assigned
Jan 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5651-33 WI Primary

Addresses

Primary practice location

2835 N Grandview Blvd
Suite 100
Pewaukee, WI 53072-5546

Mailing address

2835 N Grandview Blvd
Suite 100
Pewaukee, WI 53072-5546
Phone (262) 574-2711

Other names 1

  • Bobbiejo Garms Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140814001871 WI Practitioner - Nurse Practitioner 0547487506 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5651-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Milwaukee, LLC CurrentSince Jun 16, 2014 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Current Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC CurrentSince Jun 16, 2014 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

2835 N Grandview Blvd
Ste 100
Pewaukee, WI 53072
Phone (262) 574-1100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1376966580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 N GRANDVIEW BLVD",
            "address_2": "SUITE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725546",
            "telephone_number": "262-574-2711",
            "fax_number": "262-574-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N GRANDVIEW BLVD",
            "address_2": "SUITE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725546",
            "telephone_number": "262-574-2711",
            "fax_number": "262-574-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "BOBBIEJO",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5651-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBIEJO",
            "last_name": "GARMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.