Active NPI
Julie Ann Lisa Reynolds, APNP-BC
- Family Nurse Practitioner
- Appleton, WI
National Provider Identifier
1497054464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 7843
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 135242-30 | WI | MD | Registered Nurse |
| 7843 | WI | MD | Family 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.