Active NPI
Kathryn Demiri
- Counselor
- Oak Creek, WI
National Provider Identifier
1356695803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 5534-125
- Practice address
- 6416 S Howell Ave
Oak Creek, WI 53154-1104 - Phone
- (414) 304-5713
- Fax
- (414) 304-5721
- NPI assigned
- Nov 6, 2012
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 5534-125 | WI | Primary |
Addresses
Primary practice location
6416 S Howell Ave
Oak Creek, WI 53154-1104
Mailing address
3531 W Crest CT
Franklin, WI 53132-9333
Phone (262) 951-8480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100026714 | Medicaid | WI |
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 |
|---|---|---|---|
| 5534-125 | WI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1356695803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3531 W CREST CT",
"city": "FRANKLIN",
"state": "WI",
"postal_code": "531329333",
"telephone_number": "262-951-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6416 S HOWELL AVE",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531541104",
"telephone_number": "414-304-5713",
"fax_number": "414-304-5721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMIRI",
"first_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-06",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "5534-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100026714",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Creek, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.