Active NPI
Tamie Bennett, ADULT GERONTOLOGY NP
- Adult Health Nurse Practitioner
- Oakfield, WI
National Provider Identifier
1487051827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 5949-33
- Practice address
- 227 E Waupun St
Oakfield, WI 53065-9746 - Phone
- (920) 583-2631
- NPI assigned
- Dec 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5949-33 | WI | Primary |
Addresses
Primary practice location
227 E Waupun St
Oakfield, WI 53065-9746
Mailing address
227 E Waupun St
Oakfield, WI 53065-9746
Phone (920) 583-2631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WISCONSIN | Medicaid | WI |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5949-33 | WI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1487051827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 E WAUPUN ST",
"city": "OAKFIELD",
"state": "WI",
"postal_code": "530659746",
"telephone_number": "920-583-2631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 E WAUPUN ST",
"city": "OAKFIELD",
"state": "WI",
"postal_code": "530659746",
"telephone_number": "920-583-2631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "TAMIE",
"credential": "ADULT GERONTOLOGY NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-01",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "5949-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "WISCONSIN",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.