Ann M Kiesow, MA-CCCA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

461-156 Issued in WI

Doing business as

Ann Marie Bloom

Practice address

915 Summit Ave
Oconomowoc, WI 53066-3994

Phone

(262) 569-2300

Fax

(262) 569-2266

NPI assigned

Aug 25, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ann Marie Bloom Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1912015553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-647-6326",
            "fax_number": "414-671-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663994",
            "telephone_number": "262-569-2300",
            "fax_number": "262-569-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESOW",
        "first_name": "ANN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MA-CCCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "461-156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41149700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "BLOOM",
            "middle_name": "MARIE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heidi Dawn Kenyon, RN
• Theresa M Kerner, MA, LPC
• Kestrel Medical LLC
• Catherine D Keulks-Torinus, P.A.C.
• Evgeniya Khen, NP
• Kyle J Kircher, M.D.
• Deborah J Klecker, LPC, MFT-IT, SAC-IT
• Alyssa Klein
• David Klement, OD
• Heather Mae Klemm, LCSW

• Audiologist in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Audiologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.