Individual provider Active NPI

Karen H Nelson, M.D.

  • Family Medicine Physician
  • Waukesha, WI
National Provider Identifier
1225097405
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
52000 Issued in WI
Practice address
210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771
Phone
(262) 548-6903
Fax
(262) 548-3820
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 015291 ME
Family Medicine Physician 207Q00000X 52000 WI Primary

Addresses

Primary practice location

210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771

Mailing address

210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771
Phone (262) 548-6903

Other identifiers 5

IdentifierTypeStateIssuer
022425OtherMEANTHEM
102320000MedicaidME
2183007OtherFIRST HEALTH
4657228OtherAETNA US HEALTHCARE
1225097405MedicaidWI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
015291MEMDFamily Medicine Physician
52000WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital of Menomonee Falls, Inc Family Medicine Past Accepting new patients
Penobscot Valley Hospital Past Accepting new patients
Millinocket Regional Hospital PastSince Apr 30, 2003 Accepting new patients
Spectrum Healthcare Partners, PA Past Accepting new patients
Spectrum Healthcare Partners, P.a. Past Accepting new patients
Eastern Maine Healthcare Systems Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5664/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/penob-eadbba22

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1225097405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST",
            "address_2": "SUITE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-548-6903",
            "fax_number": "262-548-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST",
            "address_2": "SUITE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-548-6903",
            "fax_number": "262-548-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KAREN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "015291",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "52000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "022425",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102320000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2183007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "4657228",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225097405",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.