Active NPI
Gretchen Fairweather, CAPSW
- Social Worker
- Waukesha, WI
National Provider Identifier
1710235940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 127899-121
- Practice address
- 1801 Dolphin Dr
Waukesha, WI 53186-1430 - Phone
- (262) 953-8550
- NPI assigned
- Aug 20, 2012
- Last updated
- Aug 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 127899-121 | WI | Primary |
Addresses
Primary practice location
1801 Dolphin Dr
Waukesha, WI 53186-1430
Mailing address
1801 Dolphin Dr
Waukesha, WI 53186-1430
Phone (262) 953-8550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127899-121 | Other | WI | SOCIAL WORK CERTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127899-121 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345420800000",
"number": "1710235940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 DOLPHIN DR",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861430",
"telephone_number": "262-953-8550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 DOLPHIN DR",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861430",
"telephone_number": "262-953-8550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRWEATHER",
"first_name": "GRETCHEN",
"name_prefix": "Ms.",
"credential": "CAPSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-20",
"last_updated": "2012-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "127899-121",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORK CERTIFICATION",
"identifier": "127899-121",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.