Kirsten R Kallies, CCP, LP

Primary specialty

PerfusionistTaxonomy code 242T00000X

License

100-018 Issued in WI

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone

(414) 259-3000

NPI assigned

Nov 25, 2020

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1124622550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S84W23478 SHERMAN LN",
            "city": "BIG BEND",
            "state": "WI",
            "postal_code": "531039233",
            "telephone_number": "262-442-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-259-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154330",
            "country_code": "US",
            "telephone_number": "414-649-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLIES",
        "first_name": "KIRSTEN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "CCP, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "WI",
            "license": "100-018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD OF CARDIOVASCULAR PERFUSION",
            "identifier": "089006-0653",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DEPARTMENT OF REGULATION AND LICENSING",
            "identifier": "100-018",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Kalkofen, RN
• Todd Kalkoske
• Beatriz Serna Kalkowski, LPC
• Gail Silvey Kallas, MD
• Julie T Kallie, PT
• Peter Kallio, CRNA
• Timothy Patrick Kalmer, FNP
• Benie Kalongo
• Liva Kalve
• Kelli Kam, MD

• Perfusionist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Perfusionist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.