Individual provider Active NPI

Kim Marie Henrichs, N.P.

  • Women's Health Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1891785754
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
322-033 Issued in WI
Practice address
20611 Watertown Rd
Waukesha, WI 53186-1871
Phone
(262) 798-1910
Fax
(262) 798-8660
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 322-033 WI Primary

Addresses

Primary practice location

20611 Watertown Rd
Waukesha, WI 53186-1871

Mailing address

S61W24405 Red Wing Dr
Waukesha, WI 53189-9511
Phone (262) 513-3154

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
I20140722000433 WI Practitioner - Nurse Practitioner 5193941540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2315 E Moreland Blvd
Waukesha, WI 53186-2939
Phone (262) 532-5700

Hospital & facility affiliations

  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322-033WIMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2013 Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients

Locations

1905 N Calhoun Rd
Brookfield, WI 53005
Phone (262) 333-0040

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W126N7338 Flint Dr
Ste 200
Menomonee Falls, WI 53051

1271 N 6th St
Milwaukee, WI 53212
Phone (414) 978-9037

2315 E Moreland Blvd
Waukesha, WI 53186
Phone (262) 532-5700

20611 Watertown Rd
Waukesha, WI 53186
Phone (262) 798-1910

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

11211 W Lincoln Ave
West Allis, WI 53227
Phone (414) 454-8300

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1891785754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S61W24405 RED WING DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531899511",
            "telephone_number": "262-513-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20611 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861871",
            "telephone_number": "262-798-1910",
            "fax_number": "262-798-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICHS",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "322-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.