Individual provider Active NPI

Cynthia Joy McGivern, LPN

  • Licensed Practical Nurse
  • Deforest, WI
National Provider Identifier
1831432368
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
315863-31 Issued in WI
Practice address
717 Columbia Ave
De Forest, WI 53532-1333
Phone
(715) 355-7899
NPI assigned
Apr 3, 2013
Last updated
Apr 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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 315863-31 WI Primary

Addresses

Primary practice location

717 Columbia Ave
De Forest, WI 53532-1333

Mailing address

717 Columbia Ave
De Forest, WI 53532-1333
Phone (715) 355-7899

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
315863-31WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1831432368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 COLUMBIA AVE",
            "city": "DE FOREST",
            "state": "WI",
            "postal_code": "535321333",
            "telephone_number": "715-355-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 COLUMBIA AVE",
            "city": "DE FOREST",
            "state": "WI",
            "postal_code": "535321333",
            "telephone_number": "715-355-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGIVERN",
        "first_name": "CYNTHIA",
        "middle_name": "JOY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "315863-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deforest, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.

Verify at the official NPI Registry.