Individual provider Active NPI

Kevin Richard Schmidt, MSSW. LCSW

  • Clinical Social Worker
  • Viroqua, WI
National Provider Identifier
1134155658
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7260-123 Issued in WI
Practice address
407 S Main St
Viroqua, WI 54665-2100
Phone
(608) 637-3195
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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 7260-123 WI Primary

Addresses

Primary practice location

407 S Main St
Viroqua, WI 54665-2100

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other identifiers 1

IdentifierTypeStateIssuer
43592900MedicaidWI

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
I20060628000139 WI Practitioner - Clinical Social Worker 6507878022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

407 S Main St
Viroqua, WI 54665-2100
Phone (608) 637-3195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7260-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD CurrentSince May 22, 2017 Accepting new patients
Gundersen Clinic LTD Current Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince May 22, 2017 Accepting new patients
Crawford County CCS Past Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients

Locations

331 S 3rd St
La Crescent, MN 55947
Phone (507) 895-6610

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

407 S Main St
Viroqua, WI 54665
Phone (608) 637-3195

Organizations & group practices 5

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1134155658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S MAIN ST",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652100",
            "telephone_number": "608-637-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "KEVIN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "MSSW. LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7260-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43592900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Viroqua, WI

Sources for this page

Verify at the official NPI Registry.