Active NPI
Tracy L Joosten, APNP
- Nurse Practitioner
- Wisconsin Rapids, WI
National Provider Identifier
1700109196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4000
- Practice address
- 2031 Peach St
Wisconsin Rapids, WI 54494-5181 - Phone
- (715) 423-0122
- NPI assigned
- Mar 12, 2010
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4000 | WI | Primary |
Addresses
Primary practice location
2031 Peach St
Wisconsin Rapids, WI 54494-5181
Mailing address
2013 Peach Street
Wisconsin Rapids, WI 54494-8040
Phone (715) 423-0122
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4000 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334620800000",
"number": "1700109196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2013 PEACH STREET",
"city": "WISCONSIN RAPIDS",
"state": "WI",
"postal_code": "544948040",
"telephone_number": "715-423-0122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2031 PEACH ST",
"city": "WISCONSIN RAPIDS",
"state": "WI",
"postal_code": "544945181",
"telephone_number": "715-423-0122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOOSTEN",
"first_name": "TRACY",
"middle_name": "L",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-12",
"last_updated": "2012-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "4000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wisconsin Rapids, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.