Individual provider Active NPI

Irina Korolkov, RN

  • Registered Nurse
  • Franklin, WI
National Provider Identifier
1003385303
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
193680-30 Issued in WI
Practice address
9301 S Cobblestone Way Unit G
Franklin, WI 53132-7510
Phone
(414) 736-7475
NPI assigned
Nov 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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 193680-30 WI Primary

Addresses

Primary practice location

9301 S Cobblestone Way Unit G
Franklin, WI 53132-7510

Mailing address

9301 S Cobblestone Way Unit G
Franklin, WI 53132-7510
Phone (414) 736-7475

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
193680-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1003385303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 S COBBLESTONE WAY UNIT G",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531327510",
            "telephone_number": "414-736-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 S COBBLESTONE WAY UNIT G",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531327510",
            "telephone_number": "414-736-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLKOV",
        "first_name": "IRINA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "193680-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.