Individual provider Active NPI

Amy K Israel, NP

  • Nurse Practitioner
  • Greenfield, WI
National Provider Identifier
1548554686
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
159115 Issued in WI
Practice address
4131 W Loomis Rd
Suite 300
Greenfield, WI 53221-2057
Phone
(414) 325-7246
Fax
(414) 325-3770
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 159115 WI Primary
Family Nurse Practitioner 363LF0000X 159115 WI

Addresses

Primary practice location

4131 W Loomis Rd
Suite 300
Greenfield, WI 53221-2057

Mailing address

4131 W Loomis Rd
Suite 300
Greenfield, WI 53221-2057
Phone (414) 325-7246

Other names 1

  • Amy Bouressa 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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
159115WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1548554686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "SUITE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "SUITE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "AMY",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "159115",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "159115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "BOURESSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.