Carol H Kondrath, APNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1900-033 Issued in WI

Practice address

1500 N 34TH St
Superior, WI 54880-4477

Phone

(218) 730-2351

NPI assigned

May 7, 2007

Last updated

May 23, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brightwater Health Dba Human Development Center

  dba Human Development Center

  • Community/Behavioral Health Agency
  • Superior, WI
  • NPI 1407021579
  NPD (past)
• HRC Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Superior, WI
  • NPI 1922073121
  NPD (past)
• Brightwater Health Dba Human Development Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1194790733
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1417160664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EAST FIRST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-728-4404",
            "fax_number": "218-728-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N 34TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548804477",
            "telephone_number": "218-730-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDRATH",
        "first_name": "CAROL",
        "middle_name": "H",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "1900-033",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "WI",
            "license": "1900-033",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "1900003",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WI",
            "license": "1900003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40945600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGULAR MEDICARE",
            "identifier": "0007-84267",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kintop Inc
• Christina Marie Kintop, D.C.
• Thomas Myron Kintop, D.C.
• David James Kirby, MD
• Joseph Walter Knotts, SACIT
• Brenda Elaine Koneczny
• Paige M Konrad, LMFT, LPC
• Allison N Kostreba, OTR/L
• Emily Kraft, DPT
• David Kroll, MA.ED., ATC/L

• Psychiatric/Mental Health Nurse Practitioner in Superior, WI
• Providers in Superior, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.

Verify at the official NPI Registry.