Active NPI
Jo Parker
- Home Health Registered Nurse
- Boulder Junction, WI
National Provider Identifier
1881880755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- Practice address
- 5658 Wool Lake Lane
Boulder Junction, WI 54512 - Phone
- (423) 290-1024
- NPI assigned
- Sep 24, 2007
- Last updated
- Apr 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | WI | Primary |
Addresses
Primary practice location
5658 Wool Lake Lane
Boulder Junction, WI 54512
Mailing address
PO Box 501
Boulder Junction, WI 54512-0501
Phone (423) 290-1024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35039400 | Medicaid | WI |
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 |
|---|---|---|---|
| 156403-030 | WI | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207872000000",
"number": "1881880755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 501",
"city": "BOULDER JUNCTION",
"state": "WI",
"postal_code": "545120501",
"telephone_number": "423-290-1024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5658 WOOL LAKE LANE",
"city": "BOULDER JUNCTION",
"state": "WI",
"postal_code": "54512",
"telephone_number": "423-290-1024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "JO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-24",
"last_updated": "2008-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35039400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder Junction, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.