Individual provider Active NPI

Robert Donald Wurth

  • Social Worker
  • Wausau, WI
National Provider Identifier
1003247420
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1982-226 Issued in WI
Practice address
114 Grand Ave
Wausau, WI 54403-6214
Phone
(715) 845-7175
Fax
(715) 845-7142
NPI assigned
Dec 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1982-226 WI Primary

Addresses

Primary practice location

114 Grand Ave
Wausau, WI 54403-6214

Mailing address

114 Grand Ave
Wausau, WI 54403-6214
Phone (715) 845-7175

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

LicenseStateTypeSpecialty
1982-226WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elmergreen Associates,LLC PastSince Jul 1, 2015 Accepting new patients

Organizations & group practices 1

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": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1003247420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURTH",
        "first_name": "ROBERT",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "1982-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.