Individual provider Active NPI

Sarah J Arnold, PSY.D.

  • Psychologist
  • Fond Du Lac, WI
National Provider Identifier
1548393580
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2578-57 Issued in WI
Practice address
40 Camelot Dr
Fond Du Lac, WI 54935-8049
Phone
(920) 907-8201
Fax
(920) 907-8209
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2578-057 WI
Psychologist 103T00000X 2578-57 WI Primary

Addresses

Primary practice location

40 Camelot Dr
Fond Du Lac, WI 54935-8049

Mailing address

40 Camelot Dr
Fond Du Lac, WI 54935-8049
Phone (920) 907-8201

Other practice location 1

845 Parkside St
Ripon, WI 54971-8505
Phone (920) 926-4200

Other practice location 2

620 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-7600

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sarnold346156@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20220920000643 WI Practitioner - Clinical Psychologist 7810372380 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2578-57WIMDPsychologist
2578-057WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare Inc CurrentSince Aug 24, 2022 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 24, 2022 Accepting new patients
Agnesian Healthcare Inc Past Accepting new patients

Locations

401 S Military Rd
Fond du Lac, WI 54935
Phone (920) 906-6660

101 Morningside Dr
Fond du Lac, WI 54935

396 Linden St
Fond du Lac, WI 54935

371 E 1st St
Fond du Lac, WI 54935
Phone (920) 907-3928

475 W Arndt St
Fond du Lac, WI 54935

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

40 Camelot Dr
Fond du Lac, WI 54935
Phone (920) 907-8201

109 E Merrill Ave
Fond du Lac, WI 54935

525 E Pioneer Rd
Fond du Lac, WI 54935

72 W 9th St
Fond du Lac, WI 54935
Phone (920) 906-6520

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

1098 Prospect Ave
North Fond du Lac, WI 54937

325 McKinley St
North Fond du Lac, WI 54937

305 McKinley St
North Fond du Lac, WI 54937

706 Minnesota Ave
North Fond du Lac, WI 54937

845 Parkside St
Ripon, WI 54971
Phone (920) 748-3101

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Interoperability endpoints

  • Direct secure messaging: sarnold346156@direct-ehr-ssmhc.com

Organizations & group practices 4

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1548393580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CAMELOT DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358049",
            "telephone_number": "920-907-8201",
            "fax_number": "920-907-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CAMELOT DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358049",
            "telephone_number": "920-907-8201",
            "fax_number": "920-907-8209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "845 Parkside St",
            "address_purpose": "LOCATION",
            "city": "Ripon",
            "state": "WI",
            "postal_code": "549718505",
            "country_code": "US",
            "telephone_number": "920-926-4200",
            "fax_number": "920-926-8933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 W Brown St",
            "address_purpose": "LOCATION",
            "city": "Waupun",
            "state": "WI",
            "postal_code": "539631702",
            "country_code": "US",
            "telephone_number": "920-324-7600",
            "fax_number": "920-324-8459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "SARAH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2578-057",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2578-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarnold346156@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sarnold346156@direct-ehr-ssmhc.com",
            "address_1": "620 W Brown St",
            "city": "Waupun",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539631702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "620 W Brown St",
            "city": "Waupun",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539631702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.