Renee M Keranen, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7713-123 Issued in WI

Practice address

121 W Main St
Port Washington, WI 53074-1813

Phone

(262) 284-8133

Fax

(262) 284-8104

NPI assigned

Oct 10, 2014

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1023412699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741813",
            "telephone_number": "262-284-8133",
            "fax_number": "262-284-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741813",
            "telephone_number": "262-284-8133",
            "fax_number": "262-284-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERANEN",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7713-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K400202255",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "7713-123",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Jurss, RD
• Renee J Kallas
• Daniel Karrels
• Holly Marie Kempers, APNP
• Betsy A Kendziorski, LCSW
• Maja Kern, DPT
• Anna V Kleyman, D.O.
• Kimberly Burns Klug, PT
• Charmaine M Knoll, RN
• Olivia Lisette Koch, PMHNP

• Clinical Social Worker in Port Washington, WI
• Providers in Port Washington, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.