Kristen M Rose, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11395-123 Issued in WI

Practice address

320 S Walnut St
Appleton, WI 54911-5918

Phone

(920) 832-5270

Fax

(920) 832-5488

NPI assigned

Dec 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kristen M Huntington-Welch Former name

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of OutagamieGroup PAC ID 7517930019, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Outagamie

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1629138995

  WI

  Medicare reassignment Care Compare group NPD
• County of Outagamie

  • Skilled Nursing Facility
  • Appleton, WI
  • NPI 1639167430
  Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1619635901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S WALNUT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S WALNUT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "132457",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11395-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100188310",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "HUNTINGTON-WELCH",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly A Romenesko, APNP
• Michael Gavin Romenesko, DDS
• Richard Lee Romenesko Sr., D.D.S.
• Bethany Romesser, LAT, PTA
• Ronald W Schauland, Crna, LLC
• Simon Edwin Roselaar, MD
• Casey Rosendahl, D.C.
• Tanya Rosenthal
• Lori Jean Rosin, APNP
• Jennifer Ross, LPC-IT

• All providers in Appleton, WI
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.