Kimberly M Dahlke, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

7834 Issued in WI

Practice address

3509 Dewey St
Manitowoc, WI 54220

Phone

(920) 686-5732

Fax

(920) 686-5726

NPI assigned

Jul 24, 2017

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

• Kimberly M Hennings Former name

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khennings124590@direct.myadvocateaurora.org

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment NPD
• Baycare Aurora, LLC

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1255387726
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1912420852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 DEWEY ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-686-5732",
            "fax_number": "920-686-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 DEWEY ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-686-5732",
            "fax_number": "920-686-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLKE",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100069998",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3509 DEWEY ST",
            "city": "MANITOWOC",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khennings124590@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3509 DEWEY ST",
            "city": "MANITOWOC",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HENNINGS",
            "middle_name": "M",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew R Culligan, DDS
• Lori Czarneski
• Grazyna Grace Czerwonka, M.D.
• D'Vina's Adult Family Home, LLC
• Gary D Daehn, CSAC
• Melissa Ann Dallas, PTA
• Haley Davidson, M.S. CF-SLP
• Emily Ann Dawidowich, PT
• Jason G De Vries, DPM
• Jaime Debartolo, PHARMD

• Nurse Practitioner in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.

Verify at the official NPI Registry.