Individual provider Active NPI

Krista Ann Tappa

  • Family Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1083236715
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10070-33 Issued in WI
Practice address
8600 Sheridan Rd
Kenosha, WI 53143-6506
Phone
(262) 605-6721
NPI assigned
May 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10070-33 WI Primary

Addresses

Primary practice location

8600 Sheridan Rd
Kenosha, WI 53143-6506

Mailing address

8600 Sheridan Rd
Kenosha, WI 53143-6506
Phone (262) 605-6721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231025000786 WI Order and Referring Only - Nurse Practitioner 9032565270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NJM Management Services, Inc. CurrentSince May 1, 2020 Accepting new patients

Locations

8600 Sheridan Rd
Kenosha, WI 53143
Phone (262) 605-6700

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1083236715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436506",
            "telephone_number": "262-605-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436506",
            "telephone_number": "262-605-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPPA",
        "first_name": "KRISTA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-10-10",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10070-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.