Individual provider Active NPI

Renee Johnson, BSW

  • Case Manager/Care Coordinator
  • La Crosse, WI
National Provider Identifier
1174831226
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
10470-120 Issued in WI
Practice address
1407 Saint Andrew St
Suite 100
La Crosse, WI 54603-3301
Phone
(608) 785-6375
NPI assigned
Sep 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 10470-120 WI Primary

Addresses

Primary practice location

1407 Saint Andrew St
Suite 100
La Crosse, WI 54603-3301

Mailing address

W2597 Davis Creek Rd
Melrose, WI 54642-8260

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

LicenseStateTypeSpecialty
10470-120WIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1174831226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2597 DAVIS CREEK RD",
            "city": "MELROSE",
            "state": "WI",
            "postal_code": "546428260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 SAINT ANDREW ST",
            "address_2": "SUITE 100",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546033301",
            "telephone_number": "608-785-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RENEE",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WI",
            "license": "10470-120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.