Individual provider Active NPI

Jenna M Potters, RN

  • Registered Nurse
  • Waukesha, WI
National Provider Identifier
1902123813
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
166446-30 Issued in WI
Practice address
W225S3678 Foxcroft LN
Waukesha, WI 53189-8008
Phone
(414) 550-8544
NPI assigned
May 2, 2010
Last updated
Sep 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 166446-30 WI Primary

Addresses

Primary practice location

W225S3678 Foxcroft LN
Waukesha, WI 53189-8008

Mailing address

W225S3678 Foxcroft LN
Waukesha, WI 53189-8008
Phone (414) 550-8544

Other names 1

  • Ms. Jenna M Taubenheim Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
166446-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1902123813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W225S3678 FOXCROFT LN",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898008",
            "telephone_number": "414-550-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W225S3678 FOXCROFT LN",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898008",
            "telephone_number": "414-550-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTERS",
        "first_name": "JENNA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-02",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "166446-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "TAUBENHEIM",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.