Katherine M McGaver, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2155 Issued in WI

Practice address

144 E Summit Ave Ste 100
Wales, WI 53183-9546

Phone

(262) 968-6161

NPI assigned

Jun 27, 2007

Last updated

Feb 7, 2018By the provider in NPPES

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

• Ms. Katherine M Luettgen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1154528917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 E SUMMIT AVE STE 100",
            "city": "WALES",
            "state": "WI",
            "postal_code": "531839546",
            "telephone_number": "262-968-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 E SUMMIT AVE STE 100",
            "city": "WALES",
            "state": "WI",
            "postal_code": "531839546",
            "telephone_number": "262-968-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 S Oneida St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543045230",
            "country_code": "US",
            "telephone_number": "920-497-7783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 W Kinnickinnic River Parkway",
            "address_2": "Suite 930",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153692",
            "country_code": "US",
            "telephone_number": "414-384-5111",
            "fax_number": "414-643-5501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGAVER",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00823740",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "LUETTGEN",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; 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.