Individual provider Active NPI

Deborah Wessberg, BSN, RN,CDE

  • Diabetes Educator Registered Nurse
  • Menomonee Falls, WI
National Provider Identifier
1487118881
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
139940-30 Issued in WI
Practice address
200 Woodland Prime
Menomonee Falls, WI 53051-4476
Phone
(414) 777-1206
Fax
(414) 777-3767
NPI assigned
Jan 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 139940-30 WI Primary

Addresses

Primary practice location

200 Woodland Prime
Menomonee Falls, WI 53051-4476

Mailing address

200 Woodland Prime
Menomonee Falls, WI 53051-4476
Phone (414) 777-1206

Other identifiers 1

IdentifierTypeStateIssuer
139940-30OtherWIREGISTERED NURSE

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
139940-30WIMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1487118881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WOODLAND PRIME",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514476",
            "telephone_number": "414-777-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WOODLAND PRIME",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514476",
            "telephone_number": "414-777-1206",
            "fax_number": "414-777-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSBERG",
        "first_name": "DEBORAH",
        "credential": "BSN, RN,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WI",
            "license": "139940-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "139940-30",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.