Individual provider Active NPI

Keri Buslaff

  • Registered Nurse
  • Fond Du Lac, WI
National Provider Identifier
1407094030
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
143394-030 Issued in WI
Practice address
50 N Portland St
Fond Du Lac, WI 54935-3412
Phone
(920) 906-5100
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 143394-030 WI Primary

Addresses

Primary practice location

50 N Portland St
Fond Du Lac, WI 54935-3412

Mailing address

50 N Portland St
Fond Du Lac, WI 54935-3412
Phone (920) 906-5100

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

LicenseStateTypeSpecialty
143394-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1407094030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PORTLAND ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353412",
            "telephone_number": "920-906-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PORTLAND ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353412",
            "telephone_number": "920-906-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSLAFF",
        "first_name": "KERI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "143394-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.