Patricia M. Kenote-Deperry

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

19738 Issued in WI

Practice address

37390 N Bradum Rd
Bayfield, WI 54814-4832

Phone

(715) 779-3741

Fax

(715) 779-3765

NPI assigned

Oct 13, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Red Cliff Aoda Program/Mishomis House

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bayfield, WI
  • NPI 1457688863
  NPD (past)
• Red Cliff Band of Chippewa Indians

  • Addiction (Substance Use Disorder) Counselor
  • Bayfield, WI
  • NPI 1023167954
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003906009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88385 PIKE RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37390 N BRADUM RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144832",
            "telephone_number": "715-779-3741",
            "fax_number": "715-779-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENOTE-DEPERRY",
        "first_name": "PATRICIA",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Grooms, MS
• Nicole Renee Gurnoe
• Grace M Heitsch, M.D.
• Ellie Heydari, DDS
• Allyssa Kimberly Hoopman
• Tamara L Kolesar, LPC-IT, SAC-IT
• Jennifer Kupczyk, PHARM.D.
• Gail Marie Lemieux, SAC
• Michelle Lynn Macdaniels
• Theresa Matusiewicz Popovich, R.D.H

• Addiction (Substance Use Disorder) Counselor in Bayfield, WI
• Providers in Bayfield, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.