Individual provider Active NPI

Dawn Marie Krueger, LCSW, CADC

  • Clinical Social Worker
  • Greenfield, WI
National Provider Identifier
1295758738
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2727-123 Issued in WI
Practice address
4810 S 76TH St
Suite 106
Greenfield, WI 53220-4360
Phone
(414) 282-8353
Fax
(414) 282-8353
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2727-123 WI Primary

Addresses

Primary practice location

4810 S 76TH St
Suite 106
Greenfield, WI 53220-4360

Mailing address

4810 S 76TH St
Suite 106
Greenfield, WI 53220-4360
Phone (414) 282-8353

Other identifiers 1

IdentifierTypeStateIssuer
11441516OtherWICAQH #

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
I20040527000312 WI Practitioner - Clinical Social Worker 8820079601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2727-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Aug 15, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Aug 15, 2013 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295758738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 S 76TH ST",
            "address_2": "SUITE 106",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204360",
            "telephone_number": "414-282-8353",
            "fax_number": "414-282-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 S 76TH ST",
            "address_2": "SUITE 106",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204360",
            "telephone_number": "414-282-8353",
            "fax_number": "414-282-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2727-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH #",
            "identifier": "11441516",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.