Individual provider Active NPI

Jane A Fowler, NP

  • Nurse Practitioner
  • Burlington, WI
National Provider Identifier
1619264827
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4449 Issued in WI
Practice address
252 McHenry St
Burlington, WI 53105-1828
Phone
(262) 767-6000
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4449 WI Primary

Addresses

Primary practice location

252 McHenry St
Burlington, WI 53105-1828

Mailing address

252 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-6000

Other practice location 1

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-2406

Other identifiers 1

IdentifierTypeStateIssuer
100021523MedicaidWI

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

Interoperability endpoints

  • Direct secure messaging: jfowler15899@aurora.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1619264827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051828",
            "telephone_number": "262-767-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051828",
            "telephone_number": "262-767-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 American Ave",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531885031",
            "country_code": "US",
            "telephone_number": "262-928-2406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JANE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100021523",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.