Active NPI
Asheley Robyn Goergen, PAC
- Physician Assistant
- Pleasant Prairie, WI
National Provider Identifier
1720034267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1881-23
- Practice address
- 9555 76TH St Ste 1200
Pleasant Prairie, WI 53158-1984 - Phone
- (262) 671-7300
- Fax
- (262) 671-7315
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1881-23 | WI | Primary |
Addresses
Primary practice location
9555 76TH St Ste 1200
Pleasant Prairie, WI 53158-1984
Mailing address
6308 8TH Avenue
Attn: Medical Staff Office
Kenosha, WI 53143
Phone (262) 656-2218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42874700 | Medicaid | WI |
Other names 1
- Asheley Robin Kiefer
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenosha Pathology Consultants | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Kenosha, WI
- NPI 1790812857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495670400000",
"number": "1720034267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6308 8TH AVENUE",
"address_2": "ATTN: MEDICAL STAFF OFFICE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53143",
"telephone_number": "262-656-2218",
"fax_number": "262-653-5850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 76TH ST STE 1200",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531581984",
"telephone_number": "262-671-7300",
"fax_number": "262-671-7315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOERGEN",
"first_name": "ASHELEY",
"middle_name": "ROBYN",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2017-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "1881-23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42874700",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ASHELEY",
"last_name": "KIEFER",
"middle_name": "ROBIN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pleasant Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.