Individual provider Active NPI

Amber Kaesermann, REGISTERED NURSE

  • Registered Nurse
  • Watertown, WI
National Provider Identifier
1174765143
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
166234-030 Issued in WI
Practice address
115 S Concord PL
Watertown, WI 53094-5137
Phone
(920) 261-4841
NPI assigned
Apr 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 166234-030 WI Primary

Addresses

Primary practice location

115 S Concord PL
Watertown, WI 53094-5137

Mailing address

115 S Concord PL
Watertown, WI 53094-5137
Phone (920) 261-4841

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
166234-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1174765143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S CONCORD PL",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530945137",
            "telephone_number": "920-261-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S CONCORD PL",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530945137",
            "telephone_number": "920-261-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAESERMANN",
        "first_name": "AMBER",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "166234-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.