Individual provider Active NPI

Kaitlin Brianne Stieve

  • Physical Therapy Assistant
  • Glendale, WI
National Provider Identifier
1053078352
Registry record updated Nov 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3084-19 Issued in WI
Practice address
1700 W Bender Rd
Glendale, WI 53209-3852
Phone
(262) 204-5297
NPI assigned
Nov 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3084-19 WI Primary

Addresses

Primary practice location

1700 W Bender Rd
Glendale, WI 53209-3852

Mailing address

15905 W Wisconsin Ave Apt 208
Brookfield, WI 53005-5720
Phone (608) 393-6110

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

LicenseStateTypeSpecialty
3084-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1637452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637452800000",
    "number": "1053078352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15905 W WISCONSIN AVE APT 208",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055720",
            "telephone_number": "608-393-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W BENDER RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093852",
            "telephone_number": "262-204-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIEVE",
        "first_name": "KAITLIN",
        "middle_name": "BRIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-21",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "3084-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2021; 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.