Bradley Neil Koenig, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

157300 Issued in WI

Practice address

1424 Cherry St
Wausau, WI 54401-2538

Phone

(715) 675-6267

NPI assigned

Apr 22, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1548435472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 CHERRY ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012538",
            "telephone_number": "715-675-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 CHERRY ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012538",
            "telephone_number": "715-675-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "BRADLEY",
        "middle_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "157300",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "157300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38324200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista Kocha
• Kochas Interim Healthcare Inc (Interim Healthcare of Wausau)
• Jourdyn Leigh Koebe, PA-C
• Cynthia M. Koehler, PT
• Aaron Koeller, SAC-IT
• Lindsay A. Koepke, PT
• Thomas A Koepke, MD
• Jesse J Koerner, DPT
• Kelsey B Koerner, O.D.
• Peter Tongbak Koh, M.D.

• Registered Nurse in Wausau, WI
• Providers in Wausau, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.