Individual provider Active NPI

Kenneth V Schmidt, LCSW

  • Clinical Social Worker
  • Hartford, WI
National Provider Identifier
1629326012
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8041-123 Issued in WI
Practice address
112 Peace Lutheran Pkwy
Hartford, WI 53027-1159
Phone
(800) 438-1772
Fax
(262) 293-9737
NPI assigned
Aug 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8041-123 WI Primary

Addresses

Primary practice location

112 Peace Lutheran Pkwy
Hartford, WI 53027-1159

Mailing address

W175N11120 Stonewood Dr
Germantown, WI 53022-6511
Phone (800) 438-1772

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
I20170706000971 WI Practitioner - Clinical Social Worker 9739458878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Lutheran Child & Family Service Inc Clinical CurrentSince Jun 3, 2017 Accepting new patients
Wisconsin Lutheran Child and Family Service Inc Clinical CurrentSince Jun 3, 2017 Accepting new patients

Locations

W175N11120 Stonewood Dr
Germantown, WI 53022
Phone (262) 345-5533

9555 S Howell Ave
Oak Creek, WI 53154
Phone (262) 345-5560

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": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1629326012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226511",
            "telephone_number": "800-438-1772",
            "fax_number": "262-293-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PEACE LUTHERAN PKWY",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530271159",
            "telephone_number": "800-438-1772",
            "fax_number": "262-293-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "KENNETH",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-16",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8041-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, WI

Sources for this page

Verify at the official NPI Registry.