Kisa Sue Sorg

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1121107-30 Issued in WI

Practice address

S10904 Fairview Rd
Spring Green, WI 53588-9738

Phone

(608) 415-1524

NPI assigned

Dec 2, 2024

Last updated

Jun 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1164248449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S10904 FAIRVIEW RD",
            "city": "SPRING GREEN",
            "state": "WI",
            "postal_code": "535889738",
            "telephone_number": "608-415-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S10904 FAIRVIEW RD",
            "city": "SPRING GREEN",
            "state": "WI",
            "postal_code": "535889738",
            "telephone_number": "608-415-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORG",
        "first_name": "KISA",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "1121107-30",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "332331-31",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Spring Green Fire Protection District
• Spring Green Fire Protection District
• Spring Green Pharmacy Inc (Spring Green Health Mart Pharmacy)
• Spring Green Pharmacy Inc
• Spring Green Vision Center, Inc.

• Registered Nurse in Spring Green, WI
• Providers in Spring Green, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.