Carol M Retzer, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

27752-031 Issued in WI

Practice address

4555 W Schroeder Dr Ste 185
Brown Deer, WI 53223-1494

Phone

(414) 586-0222

Fax

(414) 586-0236

NPI assigned

Oct 23, 2007

Last updated

Oct 23, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• C.O.R.E.,LLC

  • Community/Behavioral Health Agency
  • Brown Deer, WI
  • NPI 1003072232
  NPD (past)
• C.O.R.E.,LLC

  • Community/Behavioral Health Agency
  • Brown Deer, WI
  • NPI 1093912768
  NPD (past)

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1427247709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 W SCHROEDER DR STE 185",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532231494",
            "telephone_number": "414-586-0222",
            "fax_number": "414-586-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 W SCHROEDER DR STE 185",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532231494",
            "telephone_number": "414-586-0222",
            "fax_number": "414-586-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETZER",
        "first_name": "CAROL",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "27752-031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42017500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Joseph Ranicke Jr., D.C.
• Cheryl Lynn Ray, MS
• Ready 2 Roll Transportation LLC
• Matthew Redmond
• Michelle Ann Reickert, MA
• Matthew M Richlen, MD
• Nicole M. Rintelman, MSN, PMHNP-BC
• Gladys Rivera, RN
• RN Private Care LLC
• Anthony Roach, PC-IT, SW

• Licensed Practical Nurse in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.