Individual provider Active NPI

Katie Lynn Cole, D.C.

  • Chiropractor
  • Milwaukee, WI
National Provider Identifier
1639200181
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4662-012 Issued in WI
Practice address
1020 N 12TH St
Milwaukee, WI 53233-1308
Phone
(414) 219-5219
Fax
(414) 219-5960
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38010309 IL
Chiropractor 111N00000X 4662-012 WI Primary

Addresses

Primary practice location

1020 N 12TH St
Milwaukee, WI 53233-1308

Mailing address

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-5219

Other practice location 1

1645 S River Rd
Suite 19
Des Plaines, IL 60018-2206
Phone (847) 296-2322

Other identifiers 2

IdentifierTypeStateIssuer
01634950OtherILBCBS
100181020MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kcole317092@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012001660 WI Practitioner - Chiropractic 1951356559 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38010309ILMDChiropractor
4662-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Oct 25, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 25, 2021 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Oct 25, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Oct 25, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 25, 2021 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

16985 W Bluemound Rd
Brookfield, WI 53005
Phone (262) 641-8400

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3305 S 20th St
Milwaukee, WI 53215
Phone (414) 384-2100

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Organizations & group practices 7

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1639200181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331308",
            "telephone_number": "414-219-5219",
            "fax_number": "414-219-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331308",
            "telephone_number": "414-219-5219",
            "fax_number": "414-219-5960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 S River Rd",
            "address_2": "Suite 19",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600182206",
            "country_code": "US",
            "telephone_number": "847-296-2322",
            "fax_number": "847-803-1943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38010309",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4662-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01634950",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100181020",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcole317092@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1020 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1020 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.