Individual provider Active NPI

Abbey Lynn Gwinnup, LCSW

  • Clinical Social Worker
  • Racine, WI
National Provider Identifier
1346977758
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9976 Issued in WI
Practice address
601 Lake Ave Ste 101C
Racine, WI 53403-1249
Phone
(262) 994-0920
NPI assigned
Aug 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 9976 WI Primary

Addresses

Primary practice location

601 Lake Ave Ste 101C
Racine, WI 53403-1249

Mailing address

6601 28TH Ave
Kenosha, WI 53143-4613
Phone (262) 994-0920

Other names 1

  • Abbey Lynn Schemel Former name

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
I20221115000530 WI Practitioner - Clinical Social Worker 5294103727 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9976WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Nov 27, 2023 Accepting new patients
Vitae Health Medical Wisconsin LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3100 Washington Rd
Kenosha, WI 53144
Phone (262) 658-4039

8633 32nd Ave
Kenosha, WI 53142
Phone (262) 694-8300

1320 Wisconsin Ave
Racine, WI 53403
Phone (262) 687-2222

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

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": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1346977758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 28TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531434613",
            "telephone_number": "262-994-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 LAKE AVE STE 101C",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031249",
            "telephone_number": "262-994-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWINNUP",
        "first_name": "ABBEY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-11-29",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBEY",
            "last_name": "SCHEMEL",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.