Kathlene A Kusiv, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

33267-021 Issued in WI

Practice address

1537 Park PL Ste 200
Green Bay, WI 54304-1974

Phone

(920) 498-8650

Fax

(920) 498-0945

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Women'S Health Care, OB-GYN, S.C.

  • Obstetrics & Gynecology Physician
  • Green Bay, WI
  • NPI 1164431862
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1073522637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 PARK PL STE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041974",
            "telephone_number": "920-498-8650",
            "fax_number": "920-498-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 PARK PL STE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041974",
            "telephone_number": "920-498-8650",
            "fax_number": "920-498-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSIV",
        "first_name": "KATHLENE",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "33267-021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31862800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WIS LICENSE",
            "identifier": "33287",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack Kumbalek
• Mandy J Kumpula, PHD
• Kayla Kuntz, LAT
• Jay J Kuritz, M.D.
• Tamara Mae Kurtz, BCBA
• Jesse F Kusserow, LPC
• Adam Ray Kuten, MD
• Russel J Kuzel, MD
• Katie Lynn Kyles, OD
• Dawn Marie La Luzerne, M.S., CCC-SLP

• Obstetrics & Gynecology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Obstetrics & Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.