Individual provider Active NPI

Kayla Himebauch

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1154014587
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023003353 Issued in WI
Practice address
10200 W Innovation Dr Ste 400
Milwaukee, WI 53226-4826
Phone
(414) 944-2000
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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 2023003353 WI Primary

Addresses

Primary practice location

10200 W Innovation Dr Ste 400
Milwaukee, WI 53226-4826

Mailing address

10200 W Innovation Dr Ste 400
Milwaukee, WI 53226-4826
Phone (414) 944-2000

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
I20240523001666 WI Practitioner - Nurse Practitioner 8527400423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Home Care Services LLCGroup PAC ID 4385961093, 101 clinicians
Sequoia Integrative Medical Services LLCGroup PAC ID 8527480250, 15 clinicians

Practice addresses (Care Compare)

Milwaukee, WI 53226
Phone (414) 944-2038

1351 Ontario Rd
Green Bay, WI 54311-8302
Phone (920) 328-1220

Hospital & facility affiliations

  • Badger Hospice Hospice, Brookfield, WI, CCN 521600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2023003353WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Home Care Services, LLC CurrentSince Apr 10, 2024 Accepting new patients
Sequoia Integrative Medical Services LLC CurrentSince Jan 19, 2026 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Apr 10, 2024 Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

10200 W Innovation Dr
Ste 400
Wauwatosa, WI 53226
Phone (414) 944-2000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1154014587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 W INNOVATION DR STE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264826",
            "telephone_number": "414-944-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 W INNOVATION DR STE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264826",
            "telephone_number": "414-944-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMEBAUCH",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2023003353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.