Individual provider Active NPI

Michelle R Wegner, PC

  • Professional Counselor
  • Tomahawk, WI
National Provider Identifier
1235579053
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1497-226 Issued in WI
Practice address
1509 N 4TH St
Suite 2
Tomahawk, WI 54487-2142
Phone
(800) 236-3792
Fax
(715) 845-6477
NPI assigned
Jun 25, 2013
Last updated
Sep 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1497-226 WI Primary

Addresses

Primary practice location

1509 N 4TH St
Suite 2
Tomahawk, WI 54487-2142

Mailing address

631 Forest St
Wausau, WI 54403-5524
Phone (715) 842-0944

Other identifiers 1

IdentifierTypeStateIssuer
1235579053MedicaidWI

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
1497-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Human Development, Inc. PastSince Jul 1, 1990 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, 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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1235579053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 FOREST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035524",
            "telephone_number": "715-842-0944",
            "fax_number": "715-845-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 N 4TH ST",
            "address_2": "SUITE 2",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544872142",
            "telephone_number": "800-236-3792",
            "fax_number": "715-845-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGNER",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1497-226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235579053",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomahawk, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.