Active NPI
Kathleen Rae Alexander, M.S.
- School Psychologist
- Medford, WI
National Provider Identifier
1902285513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 899-58
- Practice address
- N3702 Shattuck St
Medford, WI 54451-8760 - Phone
- (715) 965-1968
- NPI assigned
- May 28, 2015
- Last updated
- May 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 899-58 | WI | Primary |
Addresses
Primary practice location
N3702 Shattuck St
Medford, WI 54451-8760
Mailing address
N3702 Shattuck St
Medford, WI 54451-8760
Phone (715) 965-1968
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 899-58 | WI | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1902285513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N3702 SHATTUCK ST",
"city": "MEDFORD",
"state": "WI",
"postal_code": "544518760",
"telephone_number": "715-965-1968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N3702 SHATTUCK ST",
"city": "MEDFORD",
"state": "WI",
"postal_code": "544518760",
"telephone_number": "715-965-1968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXANDER",
"first_name": "KATHLEEN",
"middle_name": "RAE",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-28",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WI",
"license": "899-58",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.