Individual provider Active NPI

Aisha Van Bommel

  • Home Health Registered Nurse
  • Menomonee Falls, WI
National Provider Identifier
1629409388
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
149905-30 Issued in WI
Practice address
N51W16911 Old Hickory Rd
Menomonee Falls, WI 53051-7502
Phone
(262) 373-0150
Fax
(262) 718-7677
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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 149905-30 WI Primary

Addresses

Primary practice location

N51W16911 Old Hickory Rd
Menomonee Falls, WI 53051-7502

Mailing address

N51W16911 Old Hickory Rd
Menomonee Falls, WI 53051-7502
Phone (262) 373-0150

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

State licenses

LicenseStateTypeSpecialty
149905-30WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1629409388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N51W16911 OLD HICKORY RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530517502",
            "telephone_number": "262-373-0150",
            "fax_number": "262-718-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N51W16911 OLD HICKORY RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530517502",
            "telephone_number": "262-373-0150",
            "fax_number": "262-718-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BOMMEL",
        "first_name": "AISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "149905-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.