Active NPI
Anthony Edward Klingert
- Addiction (Substance Use Disorder) Counselor
- Appleton, WI
National Provider Identifier
1124542709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 18248-130
- Practice address
- 3003 N Richmond St # a
Appleton, WI 54911-1148 - Phone
- (920) 225-1737
- NPI assigned
- Jul 26, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18248-130 | WI | Primary |
Addresses
Primary practice location
3003 N Richmond St # a
Appleton, WI 54911-1148
Mailing address
1114 Red Wing TRL
De Pere, WI 54115-3290
Phone (920) 639-7972
Other practice location 1
1100 Guns Rd
Green Bay, WI 54311-6002
Phone (920) 469-7030
Other practice location 2
2366 Oak Ridge Cir
DE Pere, WI 54115-9207
Phone (920) 338-1111
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18248-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prevea Clinic, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Chippewa Falls, WI
- NPI 1588110969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1124542709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 RED WING TRL",
"city": "DE PERE",
"state": "WI",
"postal_code": "541153290",
"telephone_number": "920-639-7972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 N RICHMOND ST # A",
"city": "APPLETON",
"state": "WI",
"postal_code": "549111148",
"telephone_number": "920-225-1737"
}
],
"practiceLocations": [
{
"address_1": "1100 Guns Rd",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543116002",
"country_code": "US",
"telephone_number": "920-469-7030",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2366 Oak Ridge Cir",
"address_purpose": "LOCATION",
"city": "DE Pere",
"state": "WI",
"postal_code": "541159207",
"country_code": "US",
"telephone_number": "920-338-1111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KLINGERT",
"first_name": "ANTHONY",
"middle_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-26",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "18248-130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.