Individual provider Active NPI

Mackenzie Lyn Fischer

  • Social Worker
  • Tomah, WI
National Provider Identifier
1508556051
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
134228-121 Issued in WI
Practice address
1021 N Superior Ave Ste 10
Tomah, WI 54660-1192
Phone
(608) 886-9023
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 134228-121 WI Primary

Addresses

Primary practice location

1021 N Superior Ave Ste 10
Tomah, WI 54660-1192

Mailing address

PO Box 454
Waunakee, WI 53597-0454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
134228-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Richland CurrentSince Jun 29, 2023 Accepting new patients
Trailways LLC CurrentSince Oct 13, 2024 Accepting new patients
County of Richland CurrentSince Jun 29, 2023 Accepting new patients

Locations

221 W Seminary St
Richland Ctr, WI 53581
Phone (608) 647-8821

1021 N Superior Ave
Ste 10
Tomah, WI 54660
Phone (608) 886-9002

Organizations & group practices 3

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1508556051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 454",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535970454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N SUPERIOR AVE STE 10",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601192",
            "telephone_number": "608-886-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "MACKENZIE",
        "middle_name": "LYN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "134228-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

Verify at the official NPI Registry.