Individual provider Active NPI

Stephanie P Belzer, APSW

  • Clinical Social Worker
  • Fort Atkinson, WI
National Provider Identifier
1386670875
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2196-121 Issued in WI
Practice address
509 McMillen St
Fort Atkinson, WI 53538-1263
Phone
(920) 563-9542
Fax
(920) 568-6047
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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 2196-121 WI Primary

Addresses

Primary practice location

509 McMillen St
Fort Atkinson, WI 53538-1263

Mailing address

509 McMillen St
Fort Atkinson, WI 53538-1263
Phone (920) 563-9542

Other names 1

  • Stephanie P Simdon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2196-121WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1386670875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MCMILLEN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381263",
            "telephone_number": "920-563-9542",
            "fax_number": "920-568-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MCMILLEN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381263",
            "telephone_number": "920-563-9542",
            "fax_number": "920-568-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELZER",
        "first_name": "STEPHANIE",
        "middle_name": "P",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2196-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SIMDON",
            "middle_name": "P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Atkinson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.