Organization Active NPI

Independent Nurse

  • Nursing Facility/Intermediate Care Facility
  • Madison, WI
National Provider Identifier
1578516118
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
INDEPENDENT NURSE
Practice address
609 Copernicus Way
Madison, WI 53718-3096
Phone
(608) 467-8367
NPI assigned
May 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Elizabeth J Garwo, 164W00000XNPI 1992959167
Title
LPN
Phone
(608) 467-8367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X WI Primary

Addresses

Primary practice location

609 Copernicus Way
Madison, WI 53718-3096

Mailing address

609 Copernicus Way
Madison, WI 53718-3096

Other identifiers 1

IdentifierTypeStateIssuer
38277100MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578516118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 COPERNICUS WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 COPERNICUS WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183096",
            "telephone_number": "608-467-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT NURSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARWO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "608-467-8367",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "164W00000X"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38277100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.