Active NPI
Mario Munoz
- Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1821346362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 167664-030
- Practice address
- 302 N Jackson St
Milwaukee, WI 53202-5904 - Phone
- (414) 271-8045
- NPI assigned
- Aug 15, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 167664-030 | WI | Primary |
Addresses
Primary practice location
302 N Jackson St
Milwaukee, WI 53202-5904
Mailing address
302 N Jackson St
Milwaukee, WI 53202-5904
Phone (414) 271-8045
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
| License | State | Type | Specialty |
|---|---|---|---|
| 167664-030 | WI | MD | Nurse Practitioner |
Interoperability endpoints
- mario.munoz.p1@direct.ppwi.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1821346362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 N JACKSON ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532025904",
"telephone_number": "414-271-8045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 N JACKSON ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532025904",
"telephone_number": "414-271-8045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNOZ",
"first_name": "MARIO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-15",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "167664-030",
"primary": true
}
],
"identifiers": [],
"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 Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.