Individual provider Active NPI

Nikolaus A. Werner, PSY.D.

  • Clinical Psychologist
  • Appleton, WI
National Provider Identifier
1437426368
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2796-57 Issued in WI
Practice address
2557 E Calumet St # a
Appleton, WI 54915-4748
Phone
(920) 420-4746
NPI assigned
Nov 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2796-57 WI Primary

Addresses

Primary practice location

2557 E Calumet St # a
Appleton, WI 54915-4748

Mailing address

2557 E Calumet St # a
Appleton, WI 54915-4748
Phone (920) 420-4746

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219000316 WI Practitioner - General Practice 7416477641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calumet CountyGroup PAC ID 1254347586, 3 clinicians

Practice addresses (Care Compare)

206 Court St
Chilton, WI 53014-1127
Phone 92084914004045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2796-57WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Calumet County CurrentSince Feb 12, 2025 Accepting new patients
Calumet County CurrentSince Feb 12, 2025 Accepting new patients

Locations

206 Court St
Chilton, WI 53014
Phone (920) 849-1400

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": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1437426368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2557 E CALUMET ST # A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154748",
            "telephone_number": "920-420-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2557 E CALUMET ST # A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154748",
            "telephone_number": "920-420-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "NIKOLAUS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2796-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.