Individual provider Active NPI

Katherine Lisiecki, RN

  • Registered Nurse
  • Wisconsin Rapids, WI
National Provider Identifier
1245642446
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
144703-30 Issued in WI
Practice address
2611 12TH St S
Wisconsin Rapids, WI 54494-6445
Phone
(715) 421-8835
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 144703-30 WI Primary

Addresses

Primary practice location

2611 12TH St S
Wisconsin Rapids, WI 54494-6445

Mailing address

2611 12TH St S
Wisconsin Rapids, WI 54494-6445
Phone (715) 421-8835

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
144703-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1245642446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 12TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946445",
            "telephone_number": "715-421-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 12TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946445",
            "telephone_number": "715-421-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISIECKI",
        "first_name": "KATHERINE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "144703-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.