Individual provider Active NPI

Katrina E Blethen, APN-CNP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1467174433
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027812 Issued in IL
Practice address
2801 W Kinnickinnic River Pkwy Ste 260
Milwaukee, WI 53215-3631
Phone
(414) 649-6780
Fax
(414) 649-6030
NPI assigned
Sep 15, 2022
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209027812 IL Primary
Nurse Practitioner 363L00000X 13143 WI

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 260
Milwaukee, WI 53215-3631

Mailing address

2801 W Kinnickinnic River Pkwy Ste 260
Milwaukee, WI 53215-3631
Phone (414) 649-6780

Other practice location 1

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-7301

Other identifiers 1

IdentifierTypeStateIssuer
100216415MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kleeney200990@direct.myadvocateaurora.org Direct
Direct Messaging Address kleeney200990@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230724000136 IL Practitioner - Nurse Practitioner 2062888373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
G800
Evanston, IL 60201-1700
Phone (847) 570-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209027812ILMDNurse Practitioner
13143WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 19, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 19, 2024 Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
#G800
Evanston, IL 60201
Phone (847) 570-2639

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

199 W Rand Rd
Mt Prospect, IL 60056
Phone (847) 618-5400

Interoperability endpoints

  • Direct secure messaging: kblethen182756@direct.nch.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1467174433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 260",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153631",
            "telephone_number": "414-649-6780",
            "fax_number": "414-649-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 260",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153631",
            "telephone_number": "414-649-6780",
            "fax_number": "414-649-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "847-723-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLETHEN",
        "first_name": "KATRINA",
        "middle_name": "E",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027812",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13143",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100216415",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 260",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kleeney200990@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 260",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kleeney200990@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.