Individual provider Active NPI

Dorothy Jean Roback, APNP

  • Family Nurse Practitioner
  • Greenwood, WI
National Provider Identifier
1497760359
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1035-33 Issued in WI
Practice address
W5682 Lovers Rd
Greenwood, WI 54437-8317
Phone
(715) 937-0718
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1035-33 WI Primary

Addresses

Primary practice location

W5682 Lovers Rd
Greenwood, WI 54437-8317

Mailing address

W5682 Lovers Rd
Greenwood, WI 54437-8317
Phone (715) 937-0718

Other names 1

  • Dorothy Jean Fleming 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

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1497760359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5682 LOVERS RD",
            "city": "GREENWOOD",
            "state": "WI",
            "postal_code": "544378317",
            "telephone_number": "715-937-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5682 LOVERS RD",
            "city": "GREENWOOD",
            "state": "WI",
            "postal_code": "544378317",
            "telephone_number": "715-937-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBACK",
        "first_name": "DOROTHY",
        "middle_name": "JEAN",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1035-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHY",
            "last_name": "FLEMING",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenwood, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.