Individual provider Active NPI

Jane Antoinette Novitzke, APNP, RN, NHA

  • Gerontology Nurse Practitioner
  • Park Falls, WI
National Provider Identifier
1508942541
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
113 - 033 Issued in WI
Practice address
1133 4TH Ave S
Park Falls, WI 54552-1922
Phone
(715) 762-4600
Fax
(715) 762-2835
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 113 - 033 WI
Adult Health Nurse Practitioner 363LA2200X 113 - 033 WI
Community Health Nurse Practitioner 363LC1500X 113 - 033 WI
Gerontology Nurse Practitioner 363LG0600X 113 - 033 WI Primary

Addresses

Primary practice location

1133 4TH Ave S
Park Falls, WI 54552-1922

Mailing address

1133 4TH Ave S
Post Office Box 110
Park Falls, WI 54552-1922
Phone (715) 762-4600

Other identifiers 1

IdentifierTypeStateIssuer
43822500MedicaidWI

Other names 1

  • Mrs. Jane Antoinette Sellers 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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
113 - 033WIMDCommunity Health Nurse Practitioner
113WIMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, LTD. PastSince Jan 1, 2008 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508942541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 4TH AVE S",
            "address_2": "POST OFFICE BOX 110",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521922",
            "telephone_number": "715-762-4600",
            "fax_number": "715-762-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 4TH AVE S",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521922",
            "telephone_number": "715-762-4600",
            "fax_number": "715-762-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVITZKE",
        "first_name": "JANE",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Ms.",
        "credential": "APNP, RN, NHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "113 - 033",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "113 - 033",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "WI",
            "license": "113 - 033",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "113 - 033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43822500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "SELLERS",
            "middle_name": "ANTOINETTE",
            "prefix": "MRS.",
            "credential": "RN, NHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Park Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.