Katelyn M Kiley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3030 Issued in WI

Practice address

2845 Greenbrier Rd
Ste 340
Green Bay, WI 54311

Phone

(920) 288-8377

Fax

(920) 288-8385

NPI assigned

Sep 27, 2012

Last updated

Jul 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baycare Clinic LLP

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1588609648
  Medicare reassignment
• Green Bay Emergency Medicine Services S.C.

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1366424111
  Medicare reassignment
• Baycare Clinic LLP

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1134490758
  NPD

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1851642128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2379 JOURDAIN LN",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012137",
            "telephone_number": "920-737-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "address_2": "STE 340",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-288-8377",
            "fax_number": "920-288-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILEY",
        "first_name": "KATELYN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Anna Kieffer, D.O.
• Susan Kiehn
• Kristin Kiekhaefer
• Nathanial I Kieler, M.D.
• Jared William Kiernicki, PA-C
• Amanda Marie Kilgore, APNP
• Spenser Killgore, RN
• Jamie Michelle Killian, CRNA
• Lindsey Killian
• Jennifer Kilmer, PMHNP

• Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.

Verify at the official NPI Registry.