Active NPI
Louise M Omdahl, APNP
- Family Nurse Practitioner
- Mount Pleasant, WI
National Provider Identifier
1760720833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5208
- Practice address
- 4328 Old Green Bay Rd
Mount Pleasant, WI 53403-9489 - Phone
- (262) 687-7606
- NPI assigned
- Jan 24, 2013
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5208 | WI | Primary |
Addresses
Primary practice location
4328 Old Green Bay Rd
Mount Pleasant, WI 53403-9489
Mailing address
4328 Old Green Bay Rd
Mount Pleasant, WI 53403-9489
Phone (262) 687-7606
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5208 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380585600000",
"number": "1760720833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4328 OLD GREEN BAY RD",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534039489",
"telephone_number": "262-687-7606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4328 OLD GREEN BAY RD",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534039489",
"telephone_number": "262-687-7606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMDAHL",
"first_name": "LOUISE",
"middle_name": "M",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-24",
"last_updated": "2013-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "5208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.