Active NPI
Karen Komornicka, RN, NP
- Family Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1235126822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 799
- Practice address
- 8520 W Oklahoma Ave
Milwaukee, WI 53227-4604 - Phone
- (414) 607-4100
- Fax
- (414) 607-4502
- NPI assigned
- Sep 29, 2005
- 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 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 102451 | WI | |
| Continuing Education/Staff Development Registered Nurse | 163WC1600X | 102451 | WI | |
| Continence Care Registered Nurse | 163WC2100X | 102451 | WI | |
| General Practice Registered Nurse | 163WG0000X | 102451 | WI | |
| Gerontology Registered Nurse | 163WG0600X | 102451 | WI | |
| Wound Care Registered Nurse | 163WW0000X | 102451 | WI | |
| Ostomy Care Registered Nurse | 163WX1500X | 102451 | WI | |
| Nurse Practitioner | 363L00000X | 799 | WI | |
| Adult Health Nurse Practitioner | 363LA2200X | 799 | WI | |
| Family Nurse Practitioner | 363LF0000X | 799 | WI | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | 799 | WI | |
| Long-Term Care Clinical Nurse Specialist | 364SL0600X | 799 | WI |
Addresses
Primary practice location
8520 W Oklahoma Ave
Milwaukee, WI 53227-4604
Mailing address
3023 S 84TH St
Milwaukee, WI 53227-3703
Phone (414) 607-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 799 | Other | WI | STATE LICENSE NP |
| 102451 | Other | WI | STATE LICENSE RN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102451 | WI | MD | Continuing Education/Staff Development Registered Nurse |
Interoperability endpoints
- kkomornickaapnp14888@direct.froedtert.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1235126822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3023 S 84TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532273703",
"telephone_number": "414-607-4100",
"fax_number": "414-607-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8520 W OKLAHOMA AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532274604",
"telephone_number": "414-607-4100",
"fax_number": "414-607-4502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMORNICKA",
"first_name": "KAREN",
"credential": "RN, NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-29",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "102451",
"primary": false
},
{
"code": "163WC1600X",
"taxonomy_group": "",
"desc": "Registered Nurse, Continuing Education/Staff Development",
"state": "WI",
"license": "102451",
"primary": false
},
{
"code": "163WC2100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Continence Care",
"state": "WI",
"license": "102451",
"primary": false
},
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "WI",
"license": "102451",
"primary": false
},
{
"code": "163WG0600X",
"taxonomy_group": "",
"desc": "Registered Nurse, Gerontology",
"state": "WI",
"license": "102451",
"primary": false
},
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "WI",
"license": "102451",
"primary": false
},
{
"code": "163WX1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ostomy Care",
"state": "WI",
"license": "102451",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "799",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "799",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "799",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WI",
"license": "799",
"primary": false
},
{
"code": "364SL0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Long-Term Care",
"state": "WI",
"license": "799",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NP",
"identifier": "799",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE RN",
"identifier": "102451",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.