Individual provider Active NPI

Hailey Jo Grisham-Kerch, RN

  • Home Health Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1669288320
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
1111673 Issued in WI
Practice address
2800 N Holton St
Milwaukee, WI 53212-2522
Phone
(414) 803-0320
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 1111673 WI Primary

Addresses

Primary practice location

2800 N Holton St
Milwaukee, WI 53212-2522

Mailing address

2800 N Holton St
Milwaukee, WI 53212-2522
Phone (414) 803-0320

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1111673WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1669288320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N HOLTON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122522",
            "telephone_number": "414-803-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N HOLTON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122522",
            "telephone_number": "414-803-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM-KERCH",
        "first_name": "HAILEY",
        "middle_name": "JO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "1111673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Dec 9, 2024; 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.