Individual provider Active NPI

Caley Irene Powell, B.S.N.,R.N.

  • Home Health Registered Nurse
  • Winneconne, WI
National Provider Identifier
1609090604
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
64542-030 Issued in WI
Practice address
7185 Clarks Point Rd
Winneconne, WI 54986-9761
Phone
(920) 836-3367
Fax
(920) 836-3049
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 64542-030 WI Primary

Addresses

Primary practice location

7185 Clarks Point Rd
Winneconne, WI 54986-9761

Mailing address

7185 Clarks Point Rd
Winneconne, WI 54986-9761
Phone (920) 836-3367

Other identifiers 1

IdentifierTypeStateIssuer
39982900MedicaidWI

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
64542-030WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609090604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7185 CLARKS POINT RD",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869761",
            "telephone_number": "920-836-3367",
            "fax_number": "920-836-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7185 CLARKS POINT RD",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869761",
            "telephone_number": "920-836-3367",
            "fax_number": "920-836-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "CALEY",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "B.S.N.,R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "64542-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39982900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winneconne, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.