Keri Gregg, RN

Key facts

NPI

1629757448

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

1106245-30 (WI)

Practice address

218 N Wilson St
Fredonia, WI 53021-9482

Phone

(262) 689-3172

NPI assigned

Jul 18, 2023

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 28, 2023.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1629757448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 BACKWOODS RD",
            "city": "SLINGER",
            "state": "WI",
            "postal_code": "530869776",
            "telephone_number": "262-370-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N WILSON ST",
            "city": "FREDONIA",
            "state": "WI",
            "postal_code": "530219482",
            "telephone_number": "262-689-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "KERI",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "1106245-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Fredonia, WI · Registered Nurse in Wisconsin