Individual provider Active NPI

Julie Ann Lisa Reynolds, APNP-BC

  • Family Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1497054464
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7843 Issued in WI
Practice address
5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone
(920) 731-7445
NPI assigned
Mar 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 135242-30 WI
Nurse Practitioner 363L00000X 7843-33 WI
Family Nurse Practitioner 363LF0000X 7843 WI Primary

Addresses

Primary practice location

5337 W Grande Market Dr
Appleton, WI 54913-8442

Mailing address

5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone (920) 731-7445

Other practice location 1

555 S Washburn St
Oshkosh, WI 54904-6710
Phone (920) 230-7246

Other practice location 2

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 830-6877

Other names 1

  • Julie Ann Lisa Emmerich Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
135242-30WIMDRegistered Nurse
7843WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1497054464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5337 W GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138442",
            "telephone_number": "920-731-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5337 W GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138442",
            "telephone_number": "920-731-7445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 S Washburn St",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549046710",
            "country_code": "US",
            "telephone_number": "920-230-7246",
            "fax_number": "920-230-6544",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "54911",
            "country_code": "US",
            "telephone_number": "920-830-6877",
            "fax_number": "920-738-4792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JULIE",
        "middle_name": "ANN LISA",
        "credential": "APNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "135242-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7843-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "EMMERICH",
            "middle_name": "ANN LISA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.