Individual provider Active NPI

Brenda Lee Klingaman, P.T.A.

  • SNF/Subacute Care Certified Respiratory Therapist
  • Fall River, WI
National Provider Identifier
1144425976
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SNF/Subacute Care Certified Respiratory TherapistTaxonomy code 2278S1500X
License
240019 Issued in WI
Practice address
W758 Norway Dr
Fall River, WI 53932-8919
Phone
(920) 484-3363
NPI assigned
Jun 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SNF/Subacute Care Certified Respiratory Therapist 2278S1500X 240019 WI Primary

Addresses

Primary practice location

W758 Norway Dr
Fall River, WI 53932-8919

Mailing address

W758 Norway Dr
Fall River, WI 53932-8919
Phone (920) 484-3363

Other identifiers 1

IdentifierTypeStateIssuer
40029100MedicaidWI

Other names 1

  • Ms. Brenda Lee Klingaman Professional name

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
240019WIMDSNF/Subacute Care Certified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1144425976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W758 NORWAY DR",
            "city": "FALL RIVER",
            "state": "WI",
            "postal_code": "539328919",
            "telephone_number": "920-484-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W758 NORWAY DR",
            "city": "FALL RIVER",
            "state": "WI",
            "postal_code": "539328919",
            "telephone_number": "920-484-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGAMAN",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2278S1500X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, SNF/Subacute Care",
            "state": "WI",
            "license": "240019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40029100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "KLINGAMAN",
            "middle_name": "LEE",
            "prefix": "MS.",
            "credential": "P.T.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fall River, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.