Active NPI
Kimberly Elsia McLean
- Home Health Registered Nurse
- Mount Horeb, WI
National Provider Identifier
1205458601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 116861-30
- Practice address
- 315 S 4TH St
Mount Horeb, WI 53572-2219 - Phone
- (608) 206-3636
- NPI assigned
- May 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 116861-30 | WI | Primary |
Addresses
Primary practice location
315 S 4TH St
Mount Horeb, WI 53572-2219
Mailing address
315 S 4TH St
Mount Horeb, WI 53572-2219
Phone (608) 206-3636
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
| License | State | Type | Specialty |
|---|---|---|---|
| 116861-30 | WI | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588896000000",
"number": "1205458601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 S 4TH ST",
"city": "MOUNT HOREB",
"state": "WI",
"postal_code": "535722219",
"telephone_number": "608-206-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 S 4TH ST",
"city": "MOUNT HOREB",
"state": "WI",
"postal_code": "535722219",
"telephone_number": "608-206-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEAN",
"first_name": "KIMBERLY",
"middle_name": "ELSIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-08",
"last_updated": "2020-05-08",
"certification_date": "2020-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "WI",
"license": "116861-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Horeb, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.