Active NPI
Mary Jo Borowiecki, LIFE COACH
- Health Educator
- Evansville, IN
National Provider Identifier
1831757210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 6694126
- Practice address
- 420 Mulberry St
Evansville, IN 47713-1231 - Phone
- (812) 435-5807
- Fax
- (812) 435-6342
- NPI assigned
- May 31, 2019
- 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 |
|---|---|---|---|---|
| Health Educator | 174H00000X | 6694126 | IN | Primary |
Addresses
Primary practice location
420 Mulberry St
Evansville, IN 47713-1231
Mailing address
420 Mulberry St
Evansville, IN 47713-1231
Phone (812) 435-5807
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100241710A | Medicaid | IN | |
| 100322900 | Medicaid | IN |
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 |
|---|---|---|---|
| 6694126 | IN | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1831757210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 MULBERRY ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131231",
"telephone_number": "812-435-5807",
"fax_number": "812-435-6342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 MULBERRY ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131231",
"telephone_number": "812-435-5807",
"fax_number": "812-435-6342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOROWIECKI",
"first_name": "MARY",
"middle_name": "JO",
"credential": "LIFE COACH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-31",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "IN",
"license": "6694126",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100241710A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100322900",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.