Individual provider Active NPI

Rhianon Lyn Engelbrecht, REGISTERED NURSE

  • Pediatric Registered Nurse
  • Kenosha, WI
National Provider Identifier
1790456648
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
220756 Issued in WI
Practice address
1300 93Rd Ave
Kenosha, WI 53144-7734
Phone
(262) 220-2243
NPI assigned
Sep 21, 2021
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0200X 220756 WI Primary

Addresses

Primary practice location

1300 93Rd Ave
Kenosha, WI 53144-7734

Mailing address

1300 93Rd Ave
Kenosha, WI 53144-7734
Phone (262) 220-2243

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

State licenses

LicenseStateTypeSpecialty
220756WIMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1790456648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 93RD AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531447734",
            "telephone_number": "262-220-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 93RD AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531447734",
            "telephone_number": "262-220-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELBRECHT",
        "first_name": "RHIANON",
        "middle_name": "LYN",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Pediatrics",
            "state": "WI",
            "license": "220756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.