Individual provider Active NPI

Gloria Jean Dohearty, GNP

  • Gerontology Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1417047747
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APNP2298033 Issued in WI
Practice address
10701 W Research Dr
Milwaukee, WI 53226-3452
Phone
(414) 321-0809
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APNP2298033 WI Primary

Addresses

Primary practice location

10701 W Research Dr
Milwaukee, WI 53226-3452

Mailing address

6725 W Monona PL
West Allis, WI 53219
Phone (414) 321-0809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APNP2298033WIMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1417047747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 W MONONA PL",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53219",
            "telephone_number": "414-321-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 W RESEARCH DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263452",
            "telephone_number": "414-321-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHEARTY",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "APNP2298033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.