Individual provider Active NPI

Iesha Wynder, RN

  • Registered Nurse
  • Janesville, WI
National Provider Identifier
1518648310
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
243081-30 Issued in WI
Practice address
203 W Sunny LN
Janesville, WI 53546-9091
Phone
(608) 741-4500
Fax
(608) 741-4502
NPI assigned
Jul 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 243081-30 WI Primary

Addresses

Primary practice location

203 W Sunny LN
Janesville, WI 53546-9091

Mailing address

203 W Sunny LN
Janesville, WI 53546-9091
Phone (608) 741-4500

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
243081-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Community Programs, Inc. CurrentSince Jul 31, 2023 Accepting new patients

Locations

203 W Sunny Ln
Janesville, WI 53546
Phone (608) 741-4500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1518648310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W SUNNY LN",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535469091",
            "telephone_number": "608-741-4500",
            "fax_number": "608-741-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W SUNNY LN",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535469091",
            "telephone_number": "608-741-4500",
            "fax_number": "608-741-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNDER",
        "first_name": "IESHA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "243081-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.