Individual provider Active NPI

Kelli Deutmeyer

  • Licensed Practical Nurse
  • Madison, WI
National Provider Identifier
1619306651
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P56951 Issued in IA
Practice address
408 Parkwood LN
Apt 4
Madison, WI 53714-3549
Phone
(563) 581-6830
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P56951 IA Primary

Addresses

Primary practice location

408 Parkwood LN
Apt 4
Madison, WI 53714-3549

Mailing address

408 Parkwood LN
Apt 4
Madison, WI 53714-3549
Phone (563) 581-6830

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P56951IAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1619306651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 PARKWOOD LN",
            "address_2": "APT 4",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537143549",
            "telephone_number": "563-581-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 PARKWOOD LN",
            "address_2": "APT 4",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537143549",
            "telephone_number": "563-581-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEUTMEYER",
        "first_name": "KELLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P56951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.