Active NPI
Kellie Rae Hanson
- Physical Therapist
- Wauwatosa, WI
National Provider Identifier
1528424249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12676-24
- Practice address
- 2626 N 76TH St
Wauwatosa, WI 53213-1137 - Phone
- (414) 774-7794
- NPI assigned
- Jan 11, 2016
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12676-24 | WI | Primary |
Addresses
Primary practice location
2626 N 76TH St
Wauwatosa, WI 53213-1137
Mailing address
2626 N 76TH St
Wauwatosa, WI 53213-1137
Other names 1
- Kellie Rae Sterner
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | khanson82350@direct.myadvocateaurora.org | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12676-24 | WI | MD | Physical Therapist |
Interoperability endpoints
- khanson82350@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1528424249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2626 N 76TH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532131137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 N 76TH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532131137",
"telephone_number": "414-774-7794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "KELLIE",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-11",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12676-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2626 N 76th St",
"city": "Wauwatosa",
"state": "WI",
"country_code": "US",
"postal_code": "532131137",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khanson82350@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2626 N 76th St",
"city": "Wauwatosa",
"state": "WI",
"country_code": "US",
"postal_code": "532131137",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KELLIE",
"last_name": "STERNER",
"middle_name": "RAE",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.