Kenna Ruth Pomeroy, CAPSW, CADC-D

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

14804-13L Issued in WI

Practice address

210 W Capitol Dr
Milwaukee, WI 53212-1123

Phone

(414) 727-6320

Fax

(414) 727-6321

NPI assigned

Apr 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995

Medicare assignment

May accept Medicare assignment

Group practices

Thrive Therapy Services LLCGroup PAC ID 2062749815, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Therapy Services LLC

  • Community/Behavioral Health Agency
  • Kenosha, WI
  • NPI 1922557800
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1346469384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3166A S 16TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154525",
            "telephone_number": "414-727-6320",
            "fax_number": "414-727-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121123",
            "telephone_number": "414-727-6320",
            "fax_number": "414-727-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMEROY",
        "first_name": "KENNA",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "CAPSW, CADC-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "14804-13L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39176500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC-D",
            "identifier": "14804-13L",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joni Polzin, OTR
• Julie Polzin
• Linda Ann Pom, MS CCC SLP
• Gigi Pomerantz, APNP
• Albert Pomeranz, MD
• Jennifer Pomplin, RN
• Lauren S Pondikati, PHARMD
• Martha Kim Pontel
• Jill Pontinen
• Stephen P Pontus, MD

• Addiction (Substance Use Disorder) Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.