Active NPI
Cheryl Ann Breitlow, BSN, RN
- Registered Nurse
- Pewaukee, WI
National Provider Identifier
1669936092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 82550
- Practice address
- W264N4974 Bayberry Dr
Pewaukee, WI 53072-1114 - Phone
- (262) 224-4407
- NPI assigned
- Jan 30, 2019
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 82550 | WI | Primary |
Addresses
Primary practice location
W264N4974 Bayberry Dr
Pewaukee, WI 53072-1114
Mailing address
W264N4974 Bayberry Dr
Pewaukee, WI 53072-1114
Phone (262) 224-4407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AHT462302AHC | Other | WI | ANTHEM BLUECROSS BLUESHIELD |
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82550 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548806400000",
"number": "1669936092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W264N4974 BAYBERRY DR",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530721114",
"telephone_number": "262-224-4407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W264N4974 BAYBERRY DR",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530721114",
"telephone_number": "262-224-4407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREITLOW",
"first_name": "CHERYL",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "BSN, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-30",
"last_updated": "2019-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "82550",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUECROSS BLUESHIELD",
"identifier": "AHT462302AHC",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.