Individual provider Active NPI

Wanda Rott, RN

  • Lactation Consultant (Registered Nurse)
  • East Troy, WI
National Provider Identifier
1700318284
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L-31815 Issued in WI
Practice address
N9167 Cedar Ave
East Troy, WI 53120-2211
Phone
(262) 363-5959
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 122214 WI
Lactation Consultant (Registered Nurse) 163WL0100X L-31815 WI Primary

Addresses

Primary practice location

N9167 Cedar Ave
East Troy, WI 53120-2211

Mailing address

N9167 Cedar Ave
East Troy, WI 53120-2211

Other identifiers 1

IdentifierTypeStateIssuer
163WL0100XMedicaidWI

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

LicenseStateTypeSpecialty
122214WIMDRegistered Nurse
L-31815WIMDLactation Consultant (Registered Nurse)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1700318284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N9167 CEDAR AVE",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531202211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N9167 CEDAR AVE",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531202211",
            "telephone_number": "262-363-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTT",
        "first_name": "WANDA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "122214",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "WI",
            "license": "L-31815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163WL0100X",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Troy, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.