Maureen K Wild Gordon, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1107 Issued in WI

Practice address

600 Highland Ave
Madison, WI 53717

Phone

(608) 263-5010

Fax

(608) 265-7519

NPI assigned

Mar 30, 2006

Last updated

Mar 19, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1417918327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53717",
            "telephone_number": "608-263-5010",
            "fax_number": "608-265-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD GORDON",
        "first_name": "MAUREEN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark T Wilberg, RPH
• Renee Denise Wilberg, CAPSW, SAC-IT
• Margaret C Wilcots, M.D.
• Andrew James Wilcox, PHARMD
• Cassandra Riccioli Wilcox, MS, OTR/L
• Wild Meadows Therapy LLC
• Conner Randy Wild, SAC
• Jonathon E. Wild
• Nancy K Wild, NP
• Alexander Wilde, DPT

• Nurse Practitioner in Madison, WI
• Providers in Madison, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.