Individual provider Active NPI

Mary Ann Klingbeil, RN

  • Registered Nurse
  • New Berlin, WI
National Provider Identifier
1376134429
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
110983-30 Issued in WI
Practice address
14801 W Dakota St
New Berlin, WI 53151-3844
Phone
(414) 322-2224
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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 110983-30 WI Primary

Addresses

Primary practice location

14801 W Dakota St
New Berlin, WI 53151-3844

Mailing address

514 Riverview Ave
Waukesha, WI 53188-3631
Phone (262) 933-7397

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
110983-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1376134429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 RIVERVIEW AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883631",
            "telephone_number": "262-933-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14801 W DAKOTA ST",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513844",
            "telephone_number": "414-322-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGBEIL",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "110983-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.