Active NPI
Tina Kaquatosh
- Driver
- Keshena, WI
National Provider Identifier
1326995960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- O4258138654402
- Practice address
- N660 Hwy 47
Keshena, WI 54135-1125 - Phone
- (920) 600-7865
- NPI assigned
- Mar 12, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | O4258138654402 | WI | Primary |
Addresses
Primary practice location
N660 Hwy 47
Keshena, WI 54135-1125
Mailing address
PO Box 1125
Keshena, WI 54135-1125
Phone (920) 600-7865
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O4258138654402 | WI | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1326995960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1125",
"city": "KESHENA",
"state": "WI",
"postal_code": "541351125",
"telephone_number": "920-600-7865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N660 HWY 47",
"city": "KESHENA",
"state": "WI",
"postal_code": "541351125",
"telephone_number": "920-600-7865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAQUATOSH",
"first_name": "TINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-03-12",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Driver",
"state": "WI",
"license": "O4258138654402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keshena, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.