Individual provider Active NPI

Ann L Athorp-Krech, PHD

  • Psychologist
  • Sturgeon Bay, WI
National Provider Identifier
1639145394
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2516-057 Issued in WI
Practice address
50 S Madison Ave Ste 3
Sturgeon Bay, WI 54235-2742
Phone
(920) 743-4428
Fax
(920) 743-4681
NPI assigned
Feb 23, 2006
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2516-057 WI Primary

Addresses

Primary practice location

50 S Madison Ave Ste 3
Sturgeon Bay, WI 54235-2742

Mailing address

PO Box 321
Sturgeon Bay, WI 54235-0321
Phone (920) 562-8527

Other identifiers 1

IdentifierTypeStateIssuer
39750900MedicaidWI

Other names 1

  • Ann L Athorp Former name

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
I20041229000078 WI Practitioner - Clinical Psychologist 6204894835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

50 S Madison Ave
Suite 3
Sturgeon Bay, WI 54235-2742
Phone (920) 743-4428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2516-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Counseling Clinic, LLP CurrentSince Jul 1, 2012 Accepting new patients
Counseling Associates of Door County, LLC PastSince Feb 12, 2023 Accepting new patients

Locations

50 S Madison Ave
Ste 3
Sturgeon Bay, WI 54235
Phone (920) 743-4428

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1639145394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542350321",
            "telephone_number": "920-562-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S MADISON AVE STE 3",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542352742",
            "telephone_number": "920-743-4428",
            "fax_number": "920-743-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHORP-KRECH",
        "first_name": "ANN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2516-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39750900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "ATHORP",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sturgeon Bay, WI

Sources for this page

Verify at the official NPI Registry.