Active NPI
Kristin M Schultz, APNP
- Nurse Practitioner
- Grafton, WI
National Provider Identifier
1487999868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5183
- Practice address
- 975 Port Washington Rd
Grafton, WI 53024-9201 - Phone
- (262) 329-1000
- Fax
- (262) 329-1001
- NPI assigned
- Dec 11, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5183-33 | WI | |
| Nurse Practitioner | 363L00000X | 5183 | WI | Primary |
Addresses
Primary practice location
975 Port Washington Rd
Grafton, WI 53024-9201
Mailing address
3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (262) 329-1000
Other practice location 1
200 E Tyranena Park Road
Lake Mills, WI 53551-9678
Phone (920) 648-8393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100027676 | 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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5183-33 | WI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1487999868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 W FOREST HOME AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532152843",
"telephone_number": "262-329-1000",
"fax_number": "262-329-1001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 PORT WASHINGTON RD",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530249201",
"telephone_number": "262-329-1000",
"fax_number": "262-329-1001"
}
],
"practiceLocations": [
{
"address_1": "200 E Tyranena Park Road",
"address_purpose": "LOCATION",
"city": "Lake Mills",
"state": "WI",
"postal_code": "535519678",
"country_code": "US",
"telephone_number": "920-648-8393",
"fax_number": "920-648-3656",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCHULTZ",
"first_name": "KRISTIN",
"middle_name": "M",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-11",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "5183-33",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "5183",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100027676",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.