Jennifer Susan Kickendahl, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

56617-20 Issued in WI

Practice address

2801 W. Kinnickinnic River Parkway
Suite 1030
Milwaukee, WI 53215

Phone

(414) 908-6507

Fax

(414) 955-6528

NPI assigned

Mar 29, 2010

Last updated

Oct 1, 2014By 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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Anesthesia Partners Services, S.C.

  • Anesthesiology Physician
  • Milwaukee, WI
  • NPI 1861810947
  Medicare reassignment NPD

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1205151685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W. KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 1030",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-908-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W. KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 1030",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-908-6507",
            "fax_number": "414-955-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKENDAHL",
        "first_name": "JENNIFER",
        "middle_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "56617-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ibrahim Abdel Qader Ibrahim Khrais, M.D.
• Jessica S Khy, PHARMD
• Robyn Kibler, RDH
• Kilah M Kichura, PAC
• Colleen Kickbush
• Srividya Kidambi, M.D.
• Edom Kidane, MD
• Britney Kidd
• Charles F Kidd, MD
• Kidney Institute of Wisconsin, LLC

• Anesthesiology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Anesthesiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.

Verify at the official NPI Registry.