Active NPI
Trudy A Mandel, RN
- Registered Nurse
- Mequon, WI
National Provider Identifier
1689629214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 50665030
- Practice address
- 616 Circle Dr
Mequon, WI 53092 - Phone
- (414) 915-3066
- NPI assigned
- May 23, 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 50665030 | WI | Primary |
Addresses
Primary practice location
616 Circle Dr
Mequon, WI 53092
Mailing address
1055 12TH Ave
Grafton, WI 53024
Phone (262) 375-4471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39859400 | Medicaid | WI |
Other names 1
- Trudy A Johnson
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50665030 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1689629214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 12TH AVE",
"city": "GRAFTON",
"state": "WI",
"postal_code": "53024",
"telephone_number": "262-375-4471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 CIRCLE DR",
"city": "MEQUON",
"state": "WI",
"postal_code": "53092",
"telephone_number": "414-915-3066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDEL",
"first_name": "TRUDY",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "50665030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39859400",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TRUDY",
"last_name": "JOHNSON",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.