Individual provider Active NPI

Janet Vannatta

  • Clinical Social Worker
  • Mount Pleasant, WI
National Provider Identifier
1245516707
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2618-123 Issued in WI
Practice address
6929 Mariner Dr Ste D
Mount Pleasant, WI 53406-3950
Phone
(262) 672-6614
NPI assigned
Oct 28, 2011
Last updated
Oct 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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 2618-123 WI Primary

Addresses

Primary practice location

6929 Mariner Dr Ste D
Mount Pleasant, WI 53406-3950

Mailing address

6929 Mariner Dr Ste D
Mount Pleasant, WI 53406-3950
Phone (262) 672-6614

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
I20240311001758 WI Practitioner - Clinical Social Worker 2860838067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encompass-Effective Mental Health Services IncGroup PAC ID 0042115016, 8 clinicians

Practice addresses (Care Compare)

12970 W Bluemound Rd
Suite 301
Elm Grove, WI 53122-2607
Phone (414) 453-8380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2618-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Counseling and Wellness LLC Clinical 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": "1319760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1245516707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6929 MARINER DR STE D",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534063950",
            "telephone_number": "262-672-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6929 MARINER DR STE D",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534063950",
            "telephone_number": "262-672-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNATTA",
        "first_name": "JANET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-28",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2618-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.