Jennifer Leigh Weidner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6135-123 Issued in WI

Practice address

74 Eclipse Ctr
Beloit, WI 53511-3550

Phone

(608) 361-0311

NPI assigned

Jan 4, 2007

Sex

Female

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 2

Other names 1

• Miss Jennifer Leigh Fruin, Hough Former name

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 Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Systems IncGroup PAC ID 3678565116, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Beloit, WI
  • NPI 1750390670
  Medicare reassignment Care Compare group NPD
• Community Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Darlington, WI
  • NPI 1043981624
  NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1750438651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-361-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-361-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6135-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "6135-123",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43574600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FRUIN, HOUGH",
            "middle_name": "LEIGH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tsu-Hon Wang, MD
• Judith Marie Warnke, O.T.
• Georgia J Waterman, OTA
• Aaron D Weber, OCCUPATIONAL THERAPI
• Megan Weber
• Richard Thomas Weirich, MD
• Karlie Grace Wellnitz, RD CD
• Edythe Wells, C.P.M., L.M.
• Kiersten Wenthold, LPC
• Allison Ashley Wester, M.S. CCC-SLP

• Clinical Social Worker in Beloit, WI
• Providers in Beloit, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.