Active NPI
Kimberly M Hornbeck, M.D.
- Pediatric Sports Medicine Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Sports Medicine Physician
- License
- 55520-20
- Practice address
- 9000 W Wisconsin Ave
Pediatric Sports Medicine
Milwaukee, WI 53226-4874 - Phone
- (414) 337-7300
- Fax
- (414) 337-7337
- NPI assigned
- Jul 14, 2009
- Last updated
- Dec 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Sports Medicine Physician | 2080S0010X | 55520-20 | WI | Primary |
| Pediatric Sports Medicine Physician | 2080S0010X | 00000 | MN | |
| Pediatric Sports Medicine Physician | 2080S0010X | 49351 | AZ |
Addresses
Primary practice location
9000 W Wisconsin Ave
Pediatric Sports Medicine
Milwaukee, WI 53226-4874
Mailing address
9000 W Wisconsin Ave
Pediatric Sports Medicine
Milwaukee, WI 53226-4874
Phone (414) 337-7300
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000 | MN | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Family Medicine | Current | Accepting new patients |
| Children's Specialty Group, Inc. | Past | Accepting new patients |
Locations
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625
Interoperability endpoints
- khornbeck44595@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Family Medicine
-
- Pediatrics Physician
- Milwaukee, WI
- NPI 1942970405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449619200000",
"number": "1871723601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "PEDIATRIC SPORTS MEDICINE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-337-7300",
"fax_number": "414-337-7337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "PEDIATRIC SPORTS MEDICINE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-337-7300",
"fax_number": "414-337-7337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORNBECK",
"first_name": "KIMBERLY",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-14",
"last_updated": "2015-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2080S0010X",
"taxonomy_group": "",
"desc": "Pediatrics, Sports Medicine",
"state": "WI",
"license": "55520-20",
"primary": true
},
{
"code": "2080S0010X",
"taxonomy_group": "",
"desc": "Pediatrics, Sports Medicine",
"state": "MN",
"license": "00000",
"primary": false
},
{
"code": "2080S0010X",
"taxonomy_group": "",
"desc": "Pediatrics, Sports Medicine",
"state": "AZ",
"license": "49351",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.