Individual provider Active NPI

Kimberly Marilyn Beres, AU.D.

  • Audiologist
  • Oak Creek, WI
National Provider Identifier
1942684428
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
9431490-4101 Issued in UT
Practice address
7901 S 6TH St
Oak Creek, WI 53154-2010
Phone
(414) 346-8000
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 9431490-4101 UT Primary

Addresses

Primary practice location

7901 S 6TH St
Oak Creek, WI 53154-2010

Mailing address

7901 S 6TH St
Oak Creek, WI 53154-2010
Phone (414) 346-8000

Other practice location 1

5171 S Cottonwood St
Suite 140
Murray, UT 84107-5704
Phone (801) 507-9876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180301000545 WI Practitioner - Qualified Audiologist 0840507935 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9431490-4101UTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 24, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 24, 2023 Accepting new patients
Connect Hearing, Inc. Audiologist PastSince Dec 16, 2020 Accepting new patients
Fyzical Audiology LLC Audiologist PastSince Apr 17, 2020 Accepting new patients

Locations

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

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1942684428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 S 6TH ST",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542010",
            "telephone_number": "414-346-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 S 6TH ST",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542010",
            "telephone_number": "414-346-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5171 S Cottonwood St",
            "address_2": "Suite 140",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075704",
            "country_code": "US",
            "telephone_number": "801-507-9876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERES",
        "first_name": "KIMBERLY",
        "middle_name": "MARILYN",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "9431490-4101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.