Richard Erickson Capa, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043.117020 Issued in IL

Practice address

8207 22ND Ave
Kenosha, WI 53143-6206

Phone

(262) 653-9286

Fax

(224) 610-2601

NPI assigned

Apr 13, 2023

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1215623178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18608 W MAIN ST",
            "city": "GAGES LAKE",
            "state": "IL",
            "postal_code": "600301755",
            "telephone_number": "847-912-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436206",
            "telephone_number": "262-653-9286",
            "fax_number": "224-610-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPA",
        "first_name": "RICHARD",
        "middle_name": "ERICKSON",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.117020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.