Active NPI
Donna Christine Ertz, NP
- Adult Health Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1801297973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 9332
- Practice address
- 840 N 87TH St
Milwaukee, WI 53226-3586 - Phone
- (414) 805-6444
- Fax
- (414) 805-6702
- NPI assigned
- Sep 9, 2014
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 223054-8 | MN | |
| Nurse Practitioner | 363L00000X | APN.0993738-NP | CO | |
| Adult Health Nurse Practitioner | 363LA2200X | APN.0993738-NP | CO | |
| Adult Health Nurse Practitioner | 363LA2200X | 9332 | WI | Primary |
Addresses
Primary practice location
840 N 87TH St
Milwaukee, WI 53226-3586
Mailing address
840 N 87TH St
Milwaukee, WI 53226-3586
Phone (414) 805-6444
Other practice location 1
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801297973 | 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 |
|---|---|---|---|
| APN.0993738-NP | CO | MD | Nurse Practitioner |
| 223054-8 | MN | MD | Nurse Practitioner |
| 9332 | WI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563494400000",
"number": "1801297973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 N 87TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263586",
"telephone_number": "414-805-6444",
"fax_number": "414-805-6702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 N 87TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263586",
"telephone_number": "414-805-6444",
"fax_number": "414-805-6702"
}
],
"practiceLocations": [
{
"address_1": "9200 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263522",
"country_code": "US",
"telephone_number": "414-805-6444",
"fax_number": "414-805-6702",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ERTZ",
"first_name": "DONNA",
"middle_name": "CHRISTINE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-09",
"last_updated": "2019-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "223054-8",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "APN.0993738-NP",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CO",
"license": "APN.0993738-NP",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "9332",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1801297973",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.