Individual provider Active NPI

Kim H Squires, NP

  • Pediatric Nurse Practitioner
  • Madison, WI
National Provider Identifier
1467420620
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2256 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792
Phone
(608) 263-6420
Fax
(608) 263-6210
NPI assigned
Mar 14, 2006
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2256 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300

Other names 1

  • Kimberly H Squires Professional name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksquires29390@direct.uwhealth.org
Direct Messaging Address ksquires29390@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20101112000783 WI Practitioner - Nurse Practitioner 7315132560 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Mar 6, 2022 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jan 17, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Mar 6, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Dec 1, 2020 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Dec 1, 2020 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jan 17, 2019 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1160 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-5400

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

6001 Research Park Blvd
Madison, WI 53719
Phone (608) 232-3171

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Interoperability endpoints

  • Direct secure messaging: ksquires172894@direct.myadvocateaurora.org
  • Direct secure messaging: ksquires29390@direct.uwhealth.org
  • Direct secure messaging: ksquires6541@direct.emplifyhealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1467420620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53792",
            "telephone_number": "608-263-6420",
            "fax_number": "608-263-6210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "KIM",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "2256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksquires29390@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1675 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksquires29390@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1675 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SQUIRES",
            "middle_name": "H",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.