Individual provider Active NPI

Kasondra Kvalheim, FNP

  • Family Nurse Practitioner
  • Brookfield, WI
National Provider Identifier
1245962240
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12043-33 Issued in WI
Practice address
16535 W Bluemound Rd Ste 222
Brookfield, WI 53005-5906
Phone
(262) 754-4910
Fax
(262) 754-4913
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12043-33 WI Primary

Addresses

Primary practice location

16535 W Bluemound Rd Ste 222
Brookfield, WI 53005-5906

Mailing address

1010 E Washington St
West Bend, WI 53095-2606
Phone (414) 640-2957

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230131000101 WI Practitioner - Nurse Practitioner 5092186064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Sep 20, 2022 Accepting new patients
Chestnut Medicine of Wi LTD CurrentSince Jun 5, 2025 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

18740 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 782-0230

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

1451 Cleveland Ave
Waukesha, WI 53186
Phone (262) 547-2123

5301 W Lincoln Ave
West Allis, WI 53219
Phone (414) 615-7200

Organizations & group practices 2

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1245962240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952606",
            "telephone_number": "414-640-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16535 W BLUEMOUND RD STE 222",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055906",
            "telephone_number": "262-754-4910",
            "fax_number": "262-754-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVALHEIM",
        "first_name": "KASONDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "12043-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.