Keli R Wollmer, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

814-023 Issued in WI

Practice address

545 N 15TH St
Milwaukee, WI 53233-2237

Phone

(414) 288-7184

Fax

(414) 288-5681

NPI assigned

Jun 20, 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 1

Other names 1

• Keli R Wirth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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.

• Emergency Medical Associates LLP

  • Emergency Medicine Physician
  • Waukesha, WI
  • NPI 1861483190
  NPD (past)
• Marquette University

  • Physical Therapist
  • Milwaukee, WI
  • NPI 1396020194
  NPD (past)
• Student Health Service

  • Student Health Clinic/Center
  • Milwaukee, WI
  • NPI 1932236726
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1114962230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 N 15TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332237",
            "telephone_number": "414-288-7184",
            "fax_number": "414-288-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N 15TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332237",
            "telephone_number": "414-288-7184",
            "fax_number": "414-288-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLMER",
        "first_name": "KELI",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "814-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42966500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELI",
            "last_name": "WIRTH",
            "middle_name": "R",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rochelle Marie Wolfram, PHARMD
• Amber Wollenziehn
• Robin Faye Woller, C.O.T.A.
• Samantha Woller, MD
• Laurel Wollin, OTR
• Tanya Wollner, APNP
• Casey Wolter, AUD
• Kimberly Lynn Wolz
• Hanna Monica Womack, LICENSED PHYSICAL TH
• Women in Need

• Physician Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.