Individual provider Active NPI

Peggy Nies Scargall, MSW, CADC, CAPSW

  • Social Worker
  • Oconomowoc, WI
National Provider Identifier
1366460115
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2011-121 Issued in WI
Practice address
888 Thackeray TRL Ste 211
Oconomowoc, WI 53066-4342
Phone
(262) 613-0918
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 12735 WI
Social Worker 104100000X 2011-121 WI Primary

Addresses

Primary practice location

888 Thackeray TRL Ste 211
Oconomowoc, WI 53066-4342

Mailing address

888 Thackeray TRL Ste 211
Oconomowoc, WI 53066-4342
Phone (262) 613-0918

Other identifiers 2

IdentifierTypeStateIssuer
40929300MedicaidWI
390808738005OtherBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12735WIMDSocial Worker
2011-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew J. Schroettner, MDSC CurrentSince Aug 2, 2020 Accepting new patients
Mark H Rossing MDSC PastSince Aug 2, 2020 Accepting new patients
Allied Counseling Services, S.C. Past Accepting new patients

Locations

888 Thackeray Trl
Ste 211
Oconomowoc, WI 53066
Phone (262) 567-1122

Organizations & group practices 3

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1366460115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 211",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-613-0918",
            "fax_number": "262-646-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 211",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-613-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARGALL",
        "first_name": "PEGGY",
        "middle_name": "NIES",
        "credential": "MSW, CADC, CAPSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "12735",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "2011-121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40929300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "390808738005",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.