Active NPI
Kathleen Qualheim, MD
- Family Medicine Physician
- Shawano, WI
National Provider Identifier
1386689008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 32763
- Practice address
- 100 County Road B
Shawano, WI 54166-7072 - Phone
- (715) 524-2161
- Fax
- (715) 524-8164
- NPI assigned
- Jun 17, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 32763 | WI | Primary |
Addresses
Primary practice location
100 County Road B
Shawano, WI 54166-7072
Mailing address
PO Box 8003
Appleton, WI 54912-8003
Phone (920) 996-3298
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31768500 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Associates of Appleton, S.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Appleton, WI
- NPI 1841229093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327536000000",
"number": "1386689008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8003",
"city": "APPLETON",
"state": "WI",
"postal_code": "549128003",
"telephone_number": "920-996-3298",
"fax_number": "920-738-5787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 COUNTY ROAD B",
"city": "SHAWANO",
"state": "WI",
"postal_code": "541667072",
"telephone_number": "715-524-2161",
"fax_number": "715-524-8164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUALHEIM",
"first_name": "KATHLEEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-17",
"last_updated": "2012-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "32763",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31768500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shawano, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.