Individual provider Active NPI

Julie M Jensen

  • Clinical Social Worker
  • Wausau, WI
National Provider Identifier
1093983967
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
558-123 Issued in WI
Practice address
1100 Lake View Dr
Wausau, WI 54403-6785
Phone
(715) 848-4600
Fax
(715) 845-5398
NPI assigned
Feb 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 558-123 WI Primary

Addresses

Primary practice location

1100 Lake View Dr
Wausau, WI 54403-6785

Mailing address

741 N 1St St
Wausau, WI 54403-4721
Phone (715) 848-4600

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
I20080319000573 WI Practitioner - Clinical Social Worker 3577649318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 Marshall St
Suite a
Wausau, WI 54403-6738
Phone (715) 848-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
558-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Human Services Board Serving North Central Health Care Facility Current Accepting new patients
Human Services Board Serving North Central Health Care Facility CurrentSince Jul 17, 2023 Accepting new patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince Jul 17, 2023 Accepting new patients
Primary Connection Health Care, Inc. PastSince Mar 3, 2019 Accepting new patients

Locations

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

1100 Lake View Dr
Wausau, WI 54403
Phone (715) 848-4454

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1093983967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 N 1ST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034721",
            "telephone_number": "715-848-4600",
            "fax_number": "715-845-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036785",
            "telephone_number": "715-848-4600",
            "fax_number": "715-845-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JULIE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "558-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.