Individual provider Active NPI

Carmen Kober Glime, PA

  • Physician Assistant
  • Grafton, WI
National Provider Identifier
1699796763
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2001 Issued in WI
Practice address
975 Port Washington Rd
Grafton, WI 53024-9201
Phone
(262) 329-1000
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2001 WI Primary

Addresses

Primary practice location

975 Port Washington Rd
Grafton, WI 53024-9201

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 2

IdentifierTypeStateIssuer
2001OtherWISTATE LICENSE
42894700MedicaidWI

Other names 1

  • Carmen Kober Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cglime15229@direct.aurora.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
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
I20060905000488 WI Practitioner - Physician Assistant 8628072691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

248 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-8000

252 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-7000

Hospital & facility affiliations

  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Aurora Medical Ctr Oshkosh Hospital, Oshkosh, WI, CCN 520198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2001WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

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

2801 S Moorland Rd
New Berlin, WI 53151
Phone (262) 860-7800

915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300

620 15th Ave
Union Grove, WI 53182
Phone (262) 878-1211

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

205 Valley Ave
West Bend, WI 53095
Phone (262) 338-1123

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1699796763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIME",
        "first_name": "CARMEN",
        "middle_name": "KOBER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42894700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cglime15229@direct.aurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "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": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "KOBER",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.