Heather Ross

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8657-123 Issued in WI

Practice address

E7475 Rawhide Rd
New London, WI 54961-9025

Phone

(920) 531-2654

NPI assigned

Oct 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 17, 2024 through Sep 17, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: heather.ross@25254901.chartlogic.direct-ci.com

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.

• Rawhide Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, WI
  • NPI 1841334620
  NPD (past)

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1053715177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "920-538-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "920-531-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8657-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Reed, CRNA
• Jennifer E Resch, APNP
• Melody Riemer, PTA
• Lacey Rodgers
• Kristin M Roesler, APNP
• Cassandra Sue Rucks, PHARMD
• Jay T Rust Jr., PA
• Jennifer Schaffer, APNP
• Trillian Schlaeppi
• Dale L Schlais, MD

• Clinical Social Worker in New London, WI
• Providers in New London, 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 Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.