Active NPI
Rhonda S Niemi Judge, NPC
- Family Nurse Practitioner
- Kenosha, WI
National Provider Identifier
1588651244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2797-033
- Practice address
- 3710 57TH Ave
Kenosha, WI 53144-4820 - Phone
- (262) 652-1474
- NPI assigned
- Sep 28, 2005
- Last updated
- Jan 15, 2023
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2797-33 | WI | |
| Family Nurse Practitioner | 363LF0000X | 2797-033 | WI | Primary |
Addresses
Primary practice location
3710 57TH Ave
Kenosha, WI 53144-4820
Mailing address
3710 57TH Ave
Kenosha, WI 53144-4820
Phone (262) 652-1474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39-1805927 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2797 | WI | MD | Registered Dietitian |
| 2797-033 | WI | MD | Family Nurse Practitioner |
| 2797-33 | WI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673740800000",
"number": "1588651244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 57TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531444820",
"telephone_number": "262-652-1474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 57TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531444820",
"telephone_number": "262-652-1474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEMI JUDGE",
"first_name": "RHONDA",
"middle_name": "S",
"credential": "NPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-28",
"last_updated": "2023-01-15",
"certification_date": "2023-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "2797-33",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "2797-033",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39-1805927",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.