Individual provider Active NPI

Kelsey Lynn Bohr, NP

  • Family Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1851946818
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0994845-NP Issued in CO
Practice address
1212 57TH St
Kenosha, WI 53140-4069
Phone
(262) 657-6644
NPI assigned
Aug 7, 2019
Last updated
Mar 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0994845-NP CO Primary

Addresses

Primary practice location

1212 57TH St
Kenosha, WI 53140-4069

Mailing address

648 N Plankinton Ave Ste 200
Milwaukee, WI 53203-2928
Phone (665) 255-4848

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
I20211020000343 WI Practitioner - Nurse Practitioner 6800229576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vivent Health IncGroup PAC ID 1052308376, 54 clinicians

Practice addresses (Care Compare)

1212 57TH St
Kenosha, WI 53140-4069
Phone (414) 225-1568

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0994845-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vivent Health Inc CurrentSince Jul 12, 2021 Accepting new patients
Vivent Health Inc Current Accepting new patients

Locations

445 S Adams St
Green Bay, WI 54301
Phone (920) 437-7400

1212 57th St
Kenosha, WI 53140
Phone (414) 225-1568

600 Williamson St
Ste H
Madison, WI 53703
Phone (608) 252-6540

648 N Plankinton Ave
Ste 200
Milwaukee, WI 53203

820 N Plankinton Ave
Milwaukee, WI 53203
Phone (414) 225-1542

Interoperability endpoints

  • Direct secure messaging: kbohr348689@direct.ochin.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1851946818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 N PLANKINTON AVE STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032928",
            "telephone_number": "665-255-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 57TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404069",
            "telephone_number": "262-657-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHR",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0994845-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.