Individual provider Active NPI

Robert H Verwert, PH D

  • Psychologist
  • Waukesha, WI
National Provider Identifier
1174625461
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1218057 Issued in WI
Practice address
2717 N Grandview Blvd
#303 Stress Management Clinic
Waukesha, WI 53188-1660
Phone
(262) 544-6486
Fax
(262) 544-6377
NPI assigned
Sep 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1218057 WI Primary

Addresses

Primary practice location

2717 N Grandview Blvd
#303 Stress Management Clinic
Waukesha, WI 53188-1660

Mailing address

2717 N Grandview Blvd
#303 Stress Management Clinic
Waukesha, WI 53188-1660
Phone (262) 544-6486

Other identifiers 1

IdentifierTypeStateIssuer
39073800MedicaidWI

Other names 1

  • Mr. Robert H Verwoert Jr. Other name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1218057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stress Management & Mental Health Clinics PastSince Oct 2, 2004 Accepting new patients
Thousand Mile Journey LLC Past Accepting new patients

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174625461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 N GRANDVIEW BLVD",
            "address_2": "#303 STRESS MANAGEMENT CLINIC",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881660",
            "telephone_number": "262-544-6486",
            "fax_number": "262-544-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 N GRANDVIEW BLVD",
            "address_2": "#303 STRESS MANAGEMENT CLINIC",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881660",
            "telephone_number": "262-544-6486",
            "fax_number": "262-544-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERWERT",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1218057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39073800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "VERWOERT",
            "middle_name": "H",
            "prefix": "MR.",
            "suffix": "JR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.