Individual provider Active NPI

Sherilyn Catherine Klamm, RN, APNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1619154994
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1207733 Issued in WI
Practice address
3536 52ND St
Kenosha, WI 53144-2662
Phone
(262) 764-8555
Fax
(262) 842-0004
NPI assigned
Jan 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 148570030 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1207733 WI Primary

Addresses

Primary practice location

3536 52ND St
Kenosha, WI 53144-2662

Mailing address

3536 52ND St
Kenosha, WI 53144-2662
Phone (262) 764-8555

Other identifiers 1

IdentifierTypeStateIssuer
100222495MedicaidWI

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
I20230202001524 WI Practitioner - Nurse Practitioner 1254703192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenosha Human Development Services, IncGroup PAC ID 0143467720, 2 clinicians

Practice addresses (Care Compare)

3536 52ND St
Kenosha, WI 53144-2662
Phone (262) 842-0538

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
148570030WIMDRegistered Nurse
1207733WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kenosha Human Development Services, Inc CurrentSince Jan 19, 2023 Accepting new patients
Kenosha Human Development Services, Inc CurrentSince Mar 11, 2025 Accepting new patients

Locations

3536 52nd St
Kenosha, WI 53144
Phone (262) 764-8555

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1619154994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 52ND ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442662",
            "telephone_number": "262-764-8555",
            "fax_number": "262-842-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 52ND ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442662",
            "telephone_number": "262-764-8555",
            "fax_number": "262-842-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAMM",
        "first_name": "SHERILYN",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "RN, APNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "148570030",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "1207733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100222495",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.