Individual provider Active NPI

Veronica Thomson

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1396406260
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10156 Issued in WI
Practice address
111 N Jefferson St
Green Bay, WI 54301-5005
Phone
(920) 448-6000
Fax
(920) 448-6065
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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
Clinical Social Worker 1041C0700X 10156 WI Primary

Addresses

Primary practice location

111 N Jefferson St
Green Bay, WI 54301-5005

Mailing address

111 N Jefferson St
Green Bay, WI 54301-5005
Phone (920) 448-6000

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
I20231107001200 WI Practitioner - Clinical Social Worker 0941657340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10156WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Brown CurrentSince Jul 28, 2023 Accepting new patients
County of Brown CurrentSince Jul 28, 2023 Accepting new patients

Locations

3150 Gershwin Dr
Green Bay, WI 54311
Phone (920) 391-4700

111 N Jefferson St
Green Bay, WI 54301
Phone (920) 448-4425

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": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1396406260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N JEFFERSON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543015005",
            "telephone_number": "920-448-6000",
            "fax_number": "920-448-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N JEFFERSON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543015005",
            "telephone_number": "920-448-6000",
            "fax_number": "920-448-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "VERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "10156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.