Kettle Moraine Podiatry LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

KETTLE MORAINE PODIATRY LLC

Practice address

W63N127 Washington Ave
Cedarburg, WI 53012-2724

Phone

(262) 483-9424

NPI assigned

Mar 2, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Allyson Elizabeth Otten, DPMNPI 1699478305

Title

Owner

Phone

(262) 483-9424

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Allyson Otten, DPM

  • Podiatrist
  • Cedarburg, WI
  • NPI 1699478305

  WI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1174478424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W63N127 WASHINGTON AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122724",
            "telephone_number": "262-483-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W63N127 WASHINGTON AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122724",
            "telephone_number": "262-483-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTLE MORAINE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "OTTEN",
        "authorized_official_first_name": "ALLYSON",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-483-9424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Karolus
• Tamara Sue Kasper, MS, CCC-SLP, BCBA
• Michelle Kastenholz, OTR
• Hayly Kennedy
• Diane M Kerkman, LPN
• Kias Labbs
• Kias Labbs LLC
• Valerie Klippel
• Bailey May Knutson, RDN
• Melissa R Konitzer, LMT

• All providers in Cedarburg, WI
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.