Individual provider Active NPI

Brian Joseph Kondro, R.N.

  • Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1760739304
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
106268-30 Issued in WI
Practice address
1555 S Layton Blvd
Milwaukee, WI 53215-1924
Phone
(414) 902-2339
NPI assigned
Aug 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 106268-30 WI Primary

Addresses

Primary practice location

1555 S Layton Blvd
Milwaukee, WI 53215-1924

Mailing address

1555 S Layton Blvd
Milwaukee, WI 53215-1924
Phone (414) 902-2339

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
106268-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1760739304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 S LAYTON BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151924",
            "telephone_number": "414-902-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S LAYTON BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151924",
            "telephone_number": "414-902-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDRO",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "106268-30",
            "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 Aug 14, 2012; 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.