Merri Ann Gonzalez

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041224244 Issued in IL

Practice address

4279 Vesely Rd
Shell Lake, WI 54871-8105

Phone

(715) 349-5852

NPI assigned

Dec 17, 2008

Last updated

Dec 17, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1396981510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4279 VESELY RD",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548718105",
            "telephone_number": "715-349-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 VESELY RD",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548718105",
            "telephone_number": "715-349-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MERRI ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "127272-030",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041224244",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28092296A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Lemoine Dunham, MD
• Alexander Jerrold Eggen, DPT
• Cathy Marie Ekern, LPC MA
• Eydie A Farrow, APNP
• Kenneth Joe Garrison, M.D.
• Amy Janine Grandadam, RN
• Greenfield PT Comp LLC
• Allan Jay Haesemeyer, MD
• Karissa Halvorson, COTA
• Lance Fay Haseltine, M.D.

• Registered Nurse in Shell Lake, WI
• Providers in Shell Lake, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.