Active NPI
Kathleen A Becker
- Administrator Registered Nurse
- Waukesha, WI
National Provider Identifier
1902079767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 78336-030
- Practice address
- 721 American Ave
Suite 501
Waukesha, WI 53188-5071 - Phone
- (262) 928-7887
- Fax
- (272) 655-1213
- NPI assigned
- Apr 11, 2008
- Last updated
- Apr 11, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 78336-030 | WI | Primary |
Addresses
Primary practice location
721 American Ave
Suite 501
Waukesha, WI 53188-5071
Mailing address
721 American Ave
Suite 501
Waukesha, WI 53188-5071
Phone (262) 928-7887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39404600 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78336-030 | WI | MD | Administrator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207872000000",
"number": "1902079767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 AMERICAN AVE",
"address_2": "SUITE 501",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885071",
"telephone_number": "262-928-7887",
"fax_number": "272-655-1213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 AMERICAN AVE",
"address_2": "SUITE 501",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885071",
"telephone_number": "262-928-7887",
"fax_number": "272-655-1213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "KATHLEEN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-11",
"last_updated": "2008-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "WI",
"license": "78336-030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39404600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.