Individual provider Active NPI

Annemarie Huebner, PHD

  • Psychologist
  • Brookfield, WI
National Provider Identifier
1063402337
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2255057 Issued in WI
Practice address
17100 W North Ave
Suite 100
Brookfield, WI 53005-4436
Phone
(262) 786-9184
Fax
(262) 786-1906
NPI assigned
Oct 26, 2005
Last updated
Dec 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2255057 WI Primary

Addresses

Primary practice location

17100 W North Ave
Suite 100
Brookfield, WI 53005-4436

Mailing address

17100 W North Ave
Suite 100
Brookfield, WI 53005-4436
Phone (262) 786-9184

Other identifiers 1

IdentifierTypeStateIssuer
43571800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304000636 WI Practitioner - Clinical Psychologist 4587551361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16655 W Bluemound Rd
Brookfield, WI 53005-5935
Phone (262) 786-9184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2255057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Huebner & Associates LLC Psychologist CurrentSince Jan 1, 2011 Accepting new patients
Midwest Comprehensive Pain Care SC PastSince Jul 1, 2002 Accepting new patients

Locations

16655 W Bluemound Rd
Ste 330
Brookfield, WI 53005
Phone (262) 786-9184

17100 W North Ave
Ste 100
Brookfield, WI 53005
Phone (262) 786-4665

1585 S Oakwood Rd
Oshkosh, WI 54904
Phone (262) 786-9184

913 Nebraska St
Oshkosh, WI 54902
Phone (262) 786-9184

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1063402337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 W NORTH AVE",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054436",
            "telephone_number": "262-786-9184",
            "fax_number": "262-786-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 W NORTH AVE",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054436",
            "telephone_number": "262-786-9184",
            "fax_number": "262-786-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEBNER",
        "first_name": "ANNEMARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2255057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43571800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.