Active NPI
Anne Sherman, FNP
- Family Nurse Practitioner
- Mequon, WI
National Provider Identifier
1619248598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4657-33
- Practice address
- 10602 N Port Washington Rd
Suite 101
Mequon, WI 53092-5079 - Phone
- (414) 367-6376
- NPI assigned
- Jan 24, 2012
- Last updated
- Jul 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4657-33 | WI | Primary |
Addresses
Primary practice location
10602 N Port Washington Rd
Suite 101
Mequon, WI 53092-5079
Mailing address
10602 N Port Washington Rd
Suite 101
Mequon, WI 53092-5079
Phone (414) 367-6376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective May 23, 2013 through May 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4657-33 | WI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1619248598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10602 N PORT WASHINGTON RD",
"address_2": "SUITE 101",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925079",
"telephone_number": "414-367-6376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10602 N PORT WASHINGTON RD",
"address_2": "SUITE 101",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925079",
"telephone_number": "414-367-6376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERMAN",
"first_name": "ANNE",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-24",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "4657-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.