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Deactivated NPI 1891022554 Deactivated / Inactive NPI Male Practitioner

Jose M. Botello , LPN

Licensed Practical Nurse • Jefferson, WI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jose Botello has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 17, 2009
NPI Deactivation Date September 25, 2025
Total Practice Duration ~16 Years of Practice (2009 – 2025)

Professional Overview & Biography Verified Profile Summary

Jose Botello, LPN was a registered Licensed Practical Nurse practicing in Jefferson, WI. Throughout an active medical career spanning 16 years, Jose Botello provided care at the practice location at 128 DEER CREEK CT until profile deactivation on 2025-09-25.

Practice Location & Contact Primary Location

Practice Address

128 Deer Creek Ct
Apt. 5

Jefferson, WI 535491188

Telephone 9203970152

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Jefferson, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
7 Specialists

Practicing in Jefferson, WI (1775 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License WI 306116-031

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 25, 2025

Record deactivated on September 25, 2025

NPI Profile Active November 17, 2009

NPI status registered as active in NPPES database

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Updated Practice Location November 17, 2009

Registered at 128 DEER CREEK CT, APT. 5, JEFFERSON, WI 535491188 (Tel: 9203970152)

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Updated Business Mailing Address November 17, 2009

Registered at 128 DEER CREEK CT, APT. 5, JEFFERSON, WI 535491188 (Tel: 9203970152)

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Provider Name / Credentials Updated November 17, 2009

Recorded as JOSE BOTELLO, L.P.N.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 17, 2009

Licensed Practical Nurse (License #306116-031 in WI)

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Initial NPI Registration & Enumeration November 17, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891022554
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 17, 2009
Last Update: November 17, 2009
Deactivation Date: September 25, 2025

Mailing Address

128 Deer Creek Ct, Apt. 5

Jefferson, WI 535491188

Phone: 9203970152

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.