Individual provider Active NPI

Mona Elaine Mahrtyn, LPN

  • Licensed Practical Nurse
  • Wausau, WI
National Provider Identifier
1821386590
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
312659-31 Issued in WI
Practice address
1242 S 8TH Ave
Wausau, WI 54401-5903
Phone
(715) 869-8801
NPI assigned
Jul 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 312659-31 WI Primary

Addresses

Primary practice location

1242 S 8TH Ave
Wausau, WI 54401-5903

Mailing address

1242 S 8TH Ave
Wausau, WI 54401-5903
Phone (715) 869-8801

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
312659-31WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1821386590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1242 S 8TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015903",
            "telephone_number": "715-869-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 S 8TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015903",
            "telephone_number": "715-869-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHRTYN",
        "first_name": "MONA",
        "middle_name": "ELAINE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "312659-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.