Active NPI
Julie Minikowski
- Community Health Worker
- Waterford, WI
National Provider Identifier
1871973370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 47402169
- Practice address
- 207 Milwaukee Avenue
A
Waterford, WI 53185 - Phone
- (262) 534-9040
- Fax
- (262) 534-9041
- NPI assigned
- Jun 1, 2015
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 47402169 | WI | Primary |
Addresses
Primary practice location
207 Milwaukee Avenue
A
Waterford, WI 53185
Mailing address
207A Milwaukee Ave
Waterford, WI 53185
Phone (262) 534-9040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47402169 | Other | WI | COMMUNITY CARE |
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 |
|---|---|---|---|
| 47402169 | WI | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1871973370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207A MILWAUKEE AVE",
"city": "WATERFORD",
"state": "WI",
"postal_code": "53185",
"telephone_number": "262-534-9040",
"fax_number": "262-534-9041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 MILWAUKEE AVENUE",
"address_2": "A",
"city": "WATERFORD",
"state": "WI",
"postal_code": "53185",
"telephone_number": "262-534-9040",
"fax_number": "262-534-9041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINIKOWSKI",
"first_name": "JULIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-01",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "WI",
"license": "47402169",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY CARE",
"identifier": "47402169",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.