Active NPI
Kiz Robertson
- Audiologist
- Waukesha, WI
National Provider Identifier
1417097320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 39-156
- Practice address
- 1111 Delafield St Ste 102
Waukesha, WI 53188-3402 - Phone
- (262) 549-5150
- NPI assigned
- Feb 8, 2007
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 39-156 | WI | Primary |
Addresses
Primary practice location
1111 Delafield St Ste 102
Waukesha, WI 53188-3402
Mailing address
1111 Delafield St Ste 102
Waukesha, WI 53188-3402
Phone (262) 549-5150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41119700 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krobertson88373@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39 | WI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moreland Ear Nose & Throat Group LTD | 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.
-
- Specialist
- Waukesha, WI
- NPI 1861464182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1417097320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 DELAFIELD ST STE 102",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531883402",
"telephone_number": "262-549-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 DELAFIELD ST STE 102",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531883402",
"telephone_number": "262-549-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "KIZ",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WI",
"license": "39-156",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41119700",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "krobertson88373@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1111 Delafield St Ste 102",
"city": "Waukesha",
"state": "WI",
"country_code": "US",
"postal_code": "531883402",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1111 Delafield St Ste 102",
"city": "Waukesha",
"state": "WI",
"country_code": "US",
"postal_code": "531883402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.