Active NPI
Melissa Vukovich, NP
- Family Nurse Practitioner
- Greenfield, WI
National Provider Identifier
1770537672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1588-33
- Practice address
- 3365 S 103Rd St Ste 210
Greenfield, WI 53227-4108 - Phone
- (262) 814-7080
- Fax
- (262) 432-9004
- NPI assigned
- May 22, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1588-33 | WI | Primary |
Addresses
Primary practice location
3365 S 103Rd St Ste 210
Greenfield, WI 53227-4108
Mailing address
3365 S. 103Rd Street
Suite 210
Greenfield, WI 53227-4108
Phone (262) 814-7080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770537672 | Medicaid | WI |
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 |
|---|---|---|---|
| 1588-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Milwaukee, WI
- NPI 1699720086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1770537672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3365 S. 103RD STREET",
"address_2": "SUITE 210",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532274108",
"telephone_number": "262-814-7080",
"fax_number": "262-432-9004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3365 S 103RD ST STE 210",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532274108",
"telephone_number": "262-814-7080",
"fax_number": "262-432-9004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VUKOVICH",
"first_name": "MELISSA",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "1588-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1770537672",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.