Kim N Lederhaus

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

131926 Issued in WI

Practice address

740 Deerwood Ave
Neenah, WI 54956-1601

Phone

(920) 751-9600

NPI assigned

Jan 19, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment NPD
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1245477801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 DEERWOOD AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561601",
            "telephone_number": "920-751-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 DEERWOOD AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561601",
            "telephone_number": "920-751-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERHAUS",
        "first_name": "KIM",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-19",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "131926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245477801",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Smith Lauritzen I, DDS
• Jennifer A Lavia, APNP
• Brian Chun-Wah Law, M.D.
• Eric Jon Lawatsch, M.D.
• Katherine A. Leder, PT
• Rodney K Lefler, DC
• Daniel A Lemmens, PA-CU
• Anna Marie Lensmire, RN BSN
• Judy Leonard
• Maria Lepisto, CCC-SLP

• Nurse Practitioner in Neenah, WI
• Providers in Neenah, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; 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.

Verify at the official NPI Registry.