Individual provider Active NPI

Kelly D Parish

  • Registered Nurse
  • Oconomowoc, WI
National Provider Identifier
1811297989
Registry record updated Oct 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
174021 Issued in WI
Practice address
3328 N Interlaken Dr
Oconomowoc, WI 53066-4914
Phone
(262) 442-8727
Fax
(262) 567-8730
NPI assigned
Oct 23, 2010
Last updated
Oct 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2010

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 174021 WI Primary

Addresses

Primary practice location

3328 N Interlaken Dr
Oconomowoc, WI 53066-4914

Mailing address

3328 N Interlaken Dr
Oconomowoc, WI 53066-4914
Phone (262) 442-8727

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
174021WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1287792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287792000000",
    "number": "1811297989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 N INTERLAKEN DR",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664914",
            "telephone_number": "262-442-8727",
            "fax_number": "262-567-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3328 N INTERLAKEN DR",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664914",
            "telephone_number": "262-442-8727",
            "fax_number": "262-567-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISH",
        "first_name": "KELLY",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-23",
        "last_updated": "2010-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "174021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2010; 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.