Active NPI
Kristin Weitmann
- Acute Care Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1174825772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 4165-33
- Practice address
- 2901 W Kinnickinnic River Pkwy Ste 511
Milwaukee, WI 53215-3660 - Phone
- (414) 649-7246
- NPI assigned
- Dec 2, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 4165-33 | WI | Primary |
Addresses
Primary practice location
2901 W Kinnickinnic River Pkwy Ste 511
Milwaukee, WI 53215-3660
Mailing address
2901 W Kinnickinnic River Pkwy Ste 511
Milwaukee, WI 53215-3660
Phone (414) 649-7246
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230814001338 | WI | Order and Referring Only - Nurse Practitioner | 0648411843 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4165-33 | WI | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389830400000",
"number": "1174825772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 W KINNICKINNIC RIVER PKWY STE 511",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153660",
"telephone_number": "414-649-7246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 W KINNICKINNIC RIVER PKWY STE 511",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153660",
"telephone_number": "414-649-7246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEITMANN",
"first_name": "KRISTIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-02",
"last_updated": "2014-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "WI",
"license": "4165-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.