Individual provider Active NPI

Emily Ann Johnson, LCSW, SAC-IT

  • Clinical Social Worker
  • Juneau, WI
National Provider Identifier
1285107458
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9025 Issued in WI
Practice address
199 County Road DF
Juneau, WI 53039-9512
Phone
(920) 386-4094
NPI assigned
Jan 9, 2019
Last updated
Jan 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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 9025 WI Primary

Addresses

Primary practice location

199 County Road DF
Juneau, WI 53039-9512

Mailing address

199 County Road DF
Juneau, WI 53039-9512

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
I20190212002919 WI Practitioner - Clinical Social Worker 9335487669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of DodgeGroup PAC ID 2466475587, 10 clinicians

Practice addresses (Care Compare)

199 County Rd DF
Suite 3
Juneau, WI 53039-9512
Phone (920) 386-4094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9025WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Dodge CurrentSince Jan 14, 2019 Accepting new patients
County of Dodge CurrentSince Jan 14, 2019 Accepting new patients

Locations

199 County Road DF
#3
Juneau, WI 53039
Phone (920) 386-4094

199 County Road DF
Fl 3
Juneau, WI 53039
Phone (920) 386-4094

199 Cty Df
Juneau, WI 53039
Phone (262) 735-8005

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": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1285107458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 COUNTY ROAD DF",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "530399512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COUNTY ROAD DF",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "530399512",
            "telephone_number": "920-386-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "LCSW, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, WI

Sources for this page

Verify at the official NPI Registry.