Individual provider Active NPI

Meghan K Mortenson

  • Registered Nurse
  • Waukesha, WI
National Provider Identifier
1700525938
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
176520 Issued in WI
Practice address
1609 Hunter Rd
Waukesha, WI 53189-8220
Phone
(262) 524-1637
NPI assigned
Jun 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 176520 WI Primary

Addresses

Primary practice location

1609 Hunter Rd
Waukesha, WI 53189-8220

Mailing address

1674 Emerald Dr
Green Bay, WI 54311-6584
Phone (920) 265-2649

Other identifiers 1

IdentifierTypeStateIssuer
176520OtherWIWDSPS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schultz@wi.rr.com

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

State licenses

LicenseStateTypeSpecialty
176520WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1700525938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1674 EMERALD DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116584",
            "telephone_number": "920-265-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 HUNTER RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898220",
            "telephone_number": "262-524-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSON",
        "first_name": "MEGHAN",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-04",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "176520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WDSPS",
            "identifier": "176520",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schultz@wi.rr.com",
            "affiliation": "N",
            "address_1": "1609 Hunter Rd",
            "city": "Waukesha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531898220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.