Individual provider Active NPI

Chantal Maria Jacoba Wohnoutka

  • Social Worker
  • Shakopee, MN
National Provider Identifier
1063192508
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
28667 Issued in MN
Practice address
100 Fuller St S
Shakopee, MN 55379-1348
Phone
(855) 454-2963
NPI assigned
Jul 19, 2023
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 28667 MN Primary

Addresses

Primary practice location

100 Fuller St S
Shakopee, MN 55379-1348

Mailing address

2185 Elsberry Curv
Shakopee, MN 55379-4478
Phone (612) 356-3315

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
28667MNMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1063192508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 ELSBERRY CURV",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794478",
            "telephone_number": "612-356-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FULLER ST S",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791348",
            "telephone_number": "855-454-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHNOUTKA",
        "first_name": "CHANTAL",
        "middle_name": "MARIA JACOBA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "28667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.