Kelly Jean Witt-Erickson, ICSW CPC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3898-123 Issued in WI

Practice address

548 North Lake Avenue
Phillips, WI 54555

Phone

(715) 339-6453

NPI assigned

Oct 19, 2010

Last updated

Oct 19, 2010By the provider in NPPES

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 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 Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspirus Medford Hospital and Clinics IncGroup PAC ID 5799688602, 126 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aspirus Medford Hospital & Clinics, Inc.

  dba Aspirus Gilman Clinic

  • Rural Health Clinic/Center
  • Gilman, WI
  • NPI 1285703173
  Care Compare group NPD

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1801106265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5213 WORCESTER LAKE ROAD",
            "city": "PRENTICE",
            "state": "WI",
            "postal_code": "54556",
            "telephone_number": "715-360-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 NORTH LAKE AVENUE",
            "city": "PHILLIPS",
            "state": "WI",
            "postal_code": "54555",
            "telephone_number": "715-339-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT-ERICKSON",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "credential": "ICSW CPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3898-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39706000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kate Strang, RN
• Jessica J Stromberg, OD
• Julie Thomas, APNP
• Stephen J Weddle, DDS
• Carli Marie Winter, PT, DPT
• Megan Kay Ziembo, RDH

• Clinical Social Worker in Phillips, WI
• Providers in Phillips, 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 Oct 19, 2010; 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.