Individual provider Active NPI

James Patrick Tobin, R.N.

  • Registered Nurse
  • New Holstein, WI
National Provider Identifier
1578791216
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
159941-30 Issued in WI
Practice address
2129 Randolph Ave
205
New Holstein, WI 53061-1058
Phone
(920) 205-5630
NPI assigned
Jul 1, 2009
Last updated
Jul 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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 159941-30 WI Primary

Addresses

Primary practice location

2129 Randolph Ave
205
New Holstein, WI 53061-1058

Mailing address

2129 Randolph Ave
205
New Holstein, WI 53061-1058
Phone (920) 205-5630

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
159941-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1578791216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 RANDOLPH AVE",
            "address_2": "205",
            "city": "NEW HOLSTEIN",
            "state": "WI",
            "postal_code": "530611058",
            "telephone_number": "920-205-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 RANDOLPH AVE",
            "address_2": "205",
            "city": "NEW HOLSTEIN",
            "state": "WI",
            "postal_code": "530611058",
            "telephone_number": "920-205-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "JAMES",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "159941-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Holstein, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; 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.