Individual provider Active NPI

Denise M Kilway, APNP

  • Pediatric Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1811949639
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1165 Issued in WI
Practice address
9000 W Wisconsin Ave
Pediatric Gastroenterology
Milwaukee, WI 53226-4874
Phone
(414) 266-3690
Fax
(414) 266-3676
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1165 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Pediatric Gastroenterology
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Pediatric Gastroenterology
Milwaukee, WI 53226-4874
Phone (414) 266-3690

Other practice location 1

3195 Hillside Dr
Delafield, WI 53018-2189
Phone (262) 646-9950

Other identifiers 2

IdentifierTypeStateIssuer
1811949639MedicaidWI
004806261ROtherHUMANA

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
I20060627000030 WI Practitioner - Nurse Practitioner 1759393200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1165WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Specialty Group, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dkilway6505@direct.chw.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1811949639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC GASTROENTEROLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-3690",
            "fax_number": "414-266-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC GASTROENTEROLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-3690",
            "fax_number": "414-266-3676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3195 Hillside Dr",
            "address_purpose": "LOCATION",
            "city": "Delafield",
            "state": "WI",
            "postal_code": "530182189",
            "country_code": "US",
            "telephone_number": "262-646-9950",
            "fax_number": "414-266-6870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILWAY",
        "first_name": "DENISE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "1165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811949639",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "004806261R",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.