Active NPI
Therese Vanbuskirk
- Neonatal Nurse Practitioner
- Kenosha, WI
National Provider Identifier
1669614020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 1206-033
- Practice address
- 10400 75TH St.
Kenosha, WI 53142 - Phone
- (262) 948-5200
- Fax
- (262) 948-5205
- NPI assigned
- Apr 1, 2009
- 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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 1206-033 | WI | Primary |
Addresses
Primary practice location
10400 75TH St.
Kenosha, WI 53142
Mailing address
10400 75TH St.
Kenosha, WI 53142
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1206-033 | WI | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1669614020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 75TH ST.",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 75TH ST.",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53142",
"telephone_number": "262-948-5200",
"fax_number": "262-948-5205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANBUSKIRK",
"first_name": "THERESE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-01",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "WI",
"license": "1206-033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.