Individual provider Active NPI

Kamesha Seagle, MSN

  • Administrator Registered Nurse
  • Kenosha, WI
National Provider Identifier
1871298505
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
041339887 Issued in IL
Practice address
8207 22ND Ave
Kenosha, WI 53143-6206
Phone
(262) 653-9286
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 041339887 IL Primary

Addresses

Primary practice location

8207 22ND Ave
Kenosha, WI 53143-6206

Mailing address

12040 333Rd Ave
Twin Lakes, WI 53181-9495

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
041339887ILMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1871298505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 333RD AVE",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436206",
            "telephone_number": "262-653-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAGLE",
        "first_name": "KAMESHA",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "IL",
            "license": "041339887",
            "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 Apr 3, 2023; 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.