Individual provider Active NPI

Kelley McCarthy

  • Certified Registered Nurse Anesthetist
  • Greendale, WI
National Provider Identifier
1316614472
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
232136 Issued in WI
Practice address
5332 Mansfield Dr
Greendale, WI 53129-1221
Phone
(920) 858-6453
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 236126-30 WI
Certified Registered Nurse Anesthetist 367500000X 232136 WI Primary

Addresses

Primary practice location

5332 Mansfield Dr
Greendale, WI 53129-1221

Mailing address

5332 Mansfield Dr
Greendale, WI 53129-1221
Phone (920) 858-6453

Other identifiers 1

IdentifierTypeStateIssuer
100244228MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725001040 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901267806 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Association of Hospital Anesthesiologists SCGroup PAC ID 3476539875, 84 clinicians
Racine Anesthesia Services LLCGroup PAC ID 8628103777, 81 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

130 2ND St
Neenah, WI 54956-2883
Phone (920) 729-3100

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4392

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5930

Hospital & facility affiliations

  • Aurora Medical Center Sheboygan County Hospital, Sheboygan, WI, CCN 520035
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
232136WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Nurse Anesthetist, Certified Registered Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Racine Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 11, 2023 Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

1550 Midway Pl
Menasha, WI 54952
Phone (920) 727-8030

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1316614472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5332 MANSFIELD DR",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291221",
            "telephone_number": "920-858-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5332 MANSFIELD DR",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291221",
            "telephone_number": "920-858-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "236126-30",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "232136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244228",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.