Active NPI
Georgene D Sommer
- Nutritionist
- Milwaukee, WI
National Provider Identifier
1639277148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 572-029
- Practice address
- 1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203 - Phone
- (414) 672-1315
- Fax
- (414) 672-8960
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 572-029 | WI | Primary |
Addresses
Primary practice location
1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Mailing address
1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone (414) 672-1315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 621303 | Other | WI | CDR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 572-029 | WI | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639277148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1032 S CESAR E CHAVEZ DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532042203",
"telephone_number": "414-672-1315",
"fax_number": "414-672-8960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1032 S CESAR E CHAVEZ DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532042203",
"telephone_number": "414-672-1315",
"fax_number": "414-672-8960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOMMER",
"first_name": "GEORGENE",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WI",
"license": "572-029",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR",
"identifier": "621303",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.