NPIMap

Individual provider Active NPI

Wendy Sue Zeller, CICSW

  • Social Worker
  • Cedarburg, WI
National Provider Identifier
1194990655
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
3054 Issued in WI
Practice address
388 Woodside Dr
Cedarburg, WI 53012-9553
Phone
(262) 573-9519
Fax
(262) 618-4547
NPI assigned
Apr 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 3054 WI Primary

Addresses

Primary practice location

388 Woodside Dr
Cedarburg, WI 53012-9553

Mailing address

11540 N Buntrock Ave
Mequon, WI 53092-1856
Phone (262) 242-4769

Other identifiers 1

IdentifierTypeStateIssuer
39690600MedicaidWI

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

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1194990655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11540 N BUNTROCK AVE",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921856",
            "telephone_number": "262-242-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 WOODSIDE DR",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530129553",
            "telephone_number": "262-573-9519",
            "fax_number": "262-618-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLER",
        "first_name": "WENDY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "CICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "3054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39690600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.