Jeremy Edge, APSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

131182 Issued in WI

Practice address

4517 Woodgate Dr
Janesville, WI 53546-8203

Phone

(608) 580-0031

Fax

(608) 580-0038

NPI assigned

Aug 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

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  • NPI 1124746649
  NPD
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  • Sports Physician Chiropractor
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• Trivium LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
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  • NPI 1265450753
  NPD (past)
• Trivium LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Sun Prairie, WI
  • NPI 1427463066
  NPD (past)

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1407336704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 WOODGATE DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535468203",
            "telephone_number": "608-580-0031",
            "fax_number": "608-580-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4517 WOODGATE DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535468203",
            "telephone_number": "608-580-0031",
            "fax_number": "608-580-0038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535453072",
            "country_code": "US",
            "telephone_number": "608-580-0031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDGE",
        "first_name": "JEREMY",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-16",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Dye, COTA, OTR
• Jamee Lorraine Eanes
• Laurie L. Eastman, LCSW, SAC
• Deanne K Eccles Rotar, MD
• Harlan D Edelman, MD
• Madison Egan
• Adrienne Jones Elert, PA-C
• Lynae D Ellis, D.D.S., M.S.
• Warren R Ellison, MD
• Jeffrey W Elser

• Social Worker in Janesville, WI
• Providers in Janesville, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.