Active NPI
Kathleen A Desantes, MD
- Pediatrics Physician
- Verona, WI
National Provider Identifier
1225099013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 40318
- Practice address
- 3906 Caribou Rd
Verona, WI 53593-8407 - Phone
- (608) 829-2855
- NPI assigned
- Mar 31, 2006
- Last updated
- Aug 13, 2020
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 40318 | WI | Primary |
Addresses
Primary practice location
3906 Caribou Rd
Verona, WI 53593-8407
Mailing address
3906 Caribou Rd
Verona, WI 53593-8407
Other names 1
- Kathleen A Hiebert
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40318 | WI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1225099013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3906 CARIBOU RD",
"city": "VERONA",
"state": "WI",
"postal_code": "535938407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3906 CARIBOU RD",
"city": "VERONA",
"state": "WI",
"postal_code": "535938407",
"telephone_number": "608-829-2855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANTES",
"first_name": "KATHLEEN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-31",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "40318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "HIEBERT",
"middle_name": "A",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Verona, WI
- Jill L Davis, MSSW
- Dean Health Systems, Inc. (SSM Health Dean Medical Group)
- Dean Retail Services, Inc. (SSm Health Davis Duehr Dean Eye Care)
- Abigail Densing, PHARMD
- Janelle Derose, RN
- Klaus D Diem, MD
- Michelle Alexandra Dimartino, OTR
- Krista Dopf, PA C
- Dylan Charles Downs, D.M.D.
- Dr. David a. Besley, DDS, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.