Active NPI
Kayla Mae Green, RN
- Registered Nurse
- Waukesha, WI
National Provider Identifier
1467000349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 249729-30
- Practice address
- 129 E Park Ave Apt 6
Waukesha, WI 53186-4973 - Phone
- (920) 851-1527
- NPI assigned
- Sep 3, 2019
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 249729-30 | WI | Primary |
Addresses
Primary practice location
129 E Park Ave Apt 6
Waukesha, WI 53186-4973
Mailing address
129 E Park Ave Apt 6
Waukesha, WI 53186-4973
Phone (920) 851-1527
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KAYMAE2011 | Medicaid | WI | |
| 249729-30 | 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 249729-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1467000349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 E PARK AVE APT 6",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531864973",
"telephone_number": "920-851-1527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 E PARK AVE APT 6",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531864973",
"telephone_number": "920-851-1527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "KAYLA",
"middle_name": "MAE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-03",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "249729-30",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "KAYMAE2011",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "249729-30",
"state": "WI"
}
],
"endpoints": [],
"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 Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.