Active NPI
Jean Ann Warrior, PH D
- Clinical Psychologist
- Dodgeville, WI
National Provider Identifier
1487676474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1165057
- Practice address
- 1118 Professional Dr
Dodgeville, WI 53533-1176 - Phone
- (608) 935-2838
- Fax
- (608) 935-9227
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1165057 | WI | Primary |
Addresses
Primary practice location
1118 Professional Dr
Dodgeville, WI 53533-1176
Mailing address
1118 Professional Dr
Dodgeville, WI 53533-1176
Phone (608) 935-2838
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52612210115 | Other | DEAN CARE FACILITY PROVID | |
| 391612972011 | Other | BCBS FACILITY # | |
| 4220040039079100 | Medicaid | WI | |
| 447250008 | Other | WI | MEDICARE RICHLAND COUNTY H&HS |
| 849700001 | Other | DODGEVILLE |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1165057 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313971200000",
"number": "1487676474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 PROFESSIONAL DR",
"city": "DODGEVILLE",
"state": "WI",
"postal_code": "535331176",
"telephone_number": "608-935-2838",
"fax_number": "608-935-9227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 PROFESSIONAL DR",
"city": "DODGEVILLE",
"state": "WI",
"postal_code": "535331176",
"telephone_number": "608-935-2838",
"fax_number": "608-935-9227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARRIOR",
"first_name": "JEAN",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2011-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "1165057",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN CARE FACILITY PROVID",
"identifier": "52612210115",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FACILITY #",
"identifier": "391612972011",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4220040039079100",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RICHLAND COUNTY H&HS",
"identifier": "447250008",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DODGEVILLE",
"identifier": "849700001",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dodgeville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.