Individual provider Active NPI

Crystal D. Simpson

  • Social Worker
  • Wauwatosa, WI
National Provider Identifier
1467626879
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3015 N. 114TH St.
Wauwatosa, WI 53222
Phone
(414) 431-4444
Fax
(414) 431-0858
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3015 N. 114TH St.
Wauwatosa, WI 53222

Mailing address

3015 N. 114TH St.
Wauwatosa, WI 53222
Phone (414) 431-4444

Other identifiers 1

IdentifierTypeStateIssuer
41000300MedicaidWI

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
I20240313002099 WI Practitioner - Mental Health Counselor 7719323633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outreach Community Health Centers IncGroup PAC ID 1355247735, 53 clinicians

Practice addresses (Care Compare)

220 W Capitol Dr
Milwaukee, WI 53212-1185
Phone (414) 727-6320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Community Health Centers, Inc. CurrentSince Jan 29, 2024 Accepting new patients
Outreach Community Health Centers, Inc CurrentSince Jan 29, 2024 Accepting new patients

Locations

220 W Capitol Dr
Glendale, WI 53212
Phone (414) 964-9018

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1467626879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N. 114TH ST.",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53222",
            "telephone_number": "414-431-4444",
            "fax_number": "414-431-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N. 114TH ST.",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53222",
            "telephone_number": "414-431-4444",
            "fax_number": "414-431-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "CRYSTAL",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41000300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.