Individual provider Active NPI

Christopher D Peters, MSW LCSW

  • Clinical Social Worker
  • Sun Prairie, WI
National Provider Identifier
1396720587
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7053-123 Issued in WI
Practice address
10 Tower Dr
Sun Prairie, WI 53590-1239
Phone
(608) 825-3500
Fax
(608) 825-3793
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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 7053-123 WI Primary

Addresses

Primary practice location

10 Tower Dr
Sun Prairie, WI 53590-1239

Mailing address

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

Other identifiers 1

IdentifierTypeStateIssuer
1396720587MedicaidWI

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
I20100604000340 WI Practitioner - Clinical Social Worker 9830229624 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7053-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Physician Practices LLC CurrentSince Sep 1, 2015 Accepting new patients
Watertown Physician Practices LLC Current Accepting new patients
Dean Health Systems, Inc CurrentSince Jun 1, 2023 Accepting new patients
Watertown Physician Practices LLC Social Worker CurrentSince Sep 1, 2015 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jun 1, 2023 Accepting new patients

Locations

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

10 Tower Dr
Sun Prairie, WI 53590
Phone (608) 825-3008

123 Hospital Dr
Ste 110
Watertown, WI 53098
Phone (920) 261-0672

129 Hospital Dr
Watertown, WI 53098
Phone (920) 262-4800

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

Organizations & group practices 25

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.

View all 25

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems Inc 1,174 clinicians

Practice addresses (Care Compare)

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1396720587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TOWER DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901239",
            "telephone_number": "608-825-3500",
            "fax_number": "608-825-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TOWER DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901239",
            "telephone_number": "608-825-3500",
            "fax_number": "608-825-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CHRISTOPHER",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7053-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396720587",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

Verify at the official NPI Registry.