Active NPI
Anthony W Jurek, PH.D
- Clinical Psychologist
- Greenfield, WI
National Provider Identifier
1407029507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1869-057
- Practice address
- 7411 W Coldspring Rd
Greenfield, WI 53220-2813 - Phone
- (414) 328-1338
- NPI assigned
- Apr 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1869-057 | WI | Primary |
| Forensic Psychologist | 103TF0200X |
Addresses
Primary practice location
7411 W Coldspring Rd
Greenfield, WI 53220-2813
Mailing address
7411 W Coldspring Rd
Greenfield, WI 53220-2813
Phone (414) 328-1338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39117600 | Medicaid | WI |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1869-057 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1407029507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7411 W COLDSPRING RD",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532202813",
"telephone_number": "414-328-1338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7411 W COLDSPRING RD",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532202813",
"telephone_number": "414-328-1338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUREK",
"first_name": "ANTHONY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-09",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "1869-057",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39117600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.