Jeffrey C Rothweiler, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2594-057 Issued in WI

Practice address

114 Grand Ave
Wausau, WI 54403-6214

Phone

(715) 845-7175

Fax

(715) 845-7142

NPI assigned

Mar 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 Psychologist

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Elmergreen Associates, LLCGroup PAC ID 1355880329, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Elmergreen Associates,LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wausau, WI
  • NPI 1922173418
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699894782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHWEILER",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2594-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43585900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Roska, COTA
• Louis Michael Rossetti, PH.D.
• Jeffrey K Rossow, MD
• Christian Peter Roth, CRNA
• Barbara Lee Rothweiler, PHD
• Paula Roubinek, RN
• Roundys Supermarkets Inc (Pick 'N Save Pharmacy #53400405)
• Rodney Harold Rowland Sr., APSW
• Frank J Rubino, MD
• Bonnie Jo Ruechel, LPC

• Clinical Psychologist in Wausau, WI
• Providers in Wausau, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.