HEATHER J SORUM (NPI# 1801850524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801850524 |
| Entity Type | Individual |
| Full Name | HEATHER J SORUM |
| Credential | NP |
| Practice Address |
721 American Ave Ste 205 Prohealth Care Diabetes Center Waukesha WI 53188-5071 |
| Practice Telephone | 2629284695 |
| Mailing Telephone | 2629284695 |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2012-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 2113 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 136222 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43979600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144265513 | Heather A Sorum | Physical Therapist | 1245 Washington Ave, Detroit Lakes, MN 56501 | 2006-06-18 |
| Street Address |
721 AMERICAN AVE STE 205 PROHEALTH CARE DIABETES CENTER |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-5071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427305408 | Rebecca E Hendrickson | Registered Nurse | 721 American Ave Ste 205, Prohealth Care Diabetes Center, Waukesha, WI 53188-5071 | 2012-08-09 |
| 1639474448 | Kathleen F. Valerius | Nurse Practitioner | 721 American Ave Ste 205, Prohealh Care Diabetes Center, Waukesha, WI 53188-5071 | 2011-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| Find all providers in zip 53188 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346849510 | Haley Gabrielle Robers | Nurse Practitioner | 1043 Dresser Ave, Waukesha, WI 53188-4980 | 2020-10-20 |
| 1700493566 | Karen Heckel | Nurse Practitioner | N17w24100 Riverwood Dr Ste 150, Waukesha, WI 53188-1177 | 2020-09-25 |
| 1003324617 | Village Primary Care Providers LLC | Nurse Practitioner | 1111 Delafield St Ste 219, Waukesha, WI 53188-3403 | 2018-01-17 |
| 1043569957 | Kathryn R Rodberg | Nurse Practitioner | 725 American Ave Employee Health, Proheatlth Care Medical Associates Inc., Waukesha, WI 53188-5031 | 2012-09-06 |
| 1235385097 | Kristine M. Zinkgraf | Nurse Practitioner | 725 American Ave Fl Center3, Prohealth Care Medical Assocaites Inc., Waukesha, WI 53188-5031 | 2008-08-13 |
| 1942232764 | Ann M Davis | Nurse Practitioner | Waukesha Memorial Hospital-oncology, 725 American Ave Suite 108, Waukesha, WI 53188 | 2006-07-06 |
| 1306802723 | Kathy Helen Reilly | Nurse Practitioner | 721 American Avenue, Suite 304, Waukesha, WI 53188 | 2006-04-25 |
| 1952900474 | Amber R Marasco | Nurse Practitioner | N17w24100 Riverwood Dr Ste 150, Waukesha, WI 53188-1177 | 2020-10-26 |
| 1043852643 | Courtney Hunt | Nurse Practitioner | 725 American Ave, Waukesha, WI 53188-5031 | 2019-10-15 |
| 1528570603 | Renee Martin | Nurse Practitioner | 725 American Ave Fl 3, Waukesha, WI 53188-5031 | 2017-10-30 |
| Find all providers in WAUKESHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.