Active NPI
Mariceta Ann Govan
- Driver
- Milwaukee, WI
National Provider Identifier
1689327314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 333 W Brown Deer Rd # 507
Milwaukee, WI 53217-2372 - Phone
- (414) 210-9959
- NPI assigned
- Feb 2, 2022
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | Primary |
Addresses
Primary practice location
333 W Brown Deer Rd # 507
Milwaukee, WI 53217-2372
Mailing address
333 West Brown Deer Rd
Suiteg-507
Milwaukee, WI 53217
Phone (414) 210-9959
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Offline | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1689327314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 WEST BROWN DEER RD",
"address_2": "SUITEG-507",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53217",
"telephone_number": "414-210-9959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 W BROWN DEER RD # 507",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532172372",
"telephone_number": "414-210-9959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOVAN",
"first_name": "MARICETA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-02",
"last_updated": "2022-02-02",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Offline",
"affiliation": "N",
"endpointDescription": "Offline External Hard Drive",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "333 W Brown Deer Rd # 507",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532172372",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.