Individual provider Active NPI

Janice M Merten, MSW MA

  • Clinical Social Worker
  • Sheboygan, WI
National Provider Identifier
1649344888
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149007383 Issued in IL
Practice address
1923 Kaat LN
Sheboygan, WI 53081-9104
Phone
(920) 980-6808
Fax
(920) 783-8004
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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 149007383 IL Primary

Addresses

Primary practice location

1923 Kaat LN
Sheboygan, WI 53081-9104

Mailing address

1923 Kaat LN
Sheboygan, WI 53081-9104
Phone (920) 980-6808

Other identifiers 1

IdentifierTypeStateIssuer
1649344888OtherHEALTH INSURANCE COMPANIES

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL janicemertenlcsw@sbcglobal.net Health Information Exchange (HIE)

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
I20190812000879 WI Practitioner - Clinical Social Worker 4284826884 Practice locations: Sheboygan, WI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1923 Kaat LN
Sheboygan, WI 53081-9104
Phone (920) 980-6808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
149007383ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1649344888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 KAAT LN",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530819104",
            "telephone_number": "920-980-6808",
            "fax_number": "920-783-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 KAAT LN",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530819104",
            "telephone_number": "920-980-6808",
            "fax_number": "920-783-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTEN",
        "first_name": "JANICE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSW MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH INSURANCE COMPANIES",
            "identifier": "1649344888",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "janicemertenlcsw@sbcglobal.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "health information",
            "address_1": "1923 Kaat Ln",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530819104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.