Individual provider Active NPI

Megan Ketter, LCSW

  • Clinical Social Worker
  • Sheboygan, WI
National Provider Identifier
1851006761
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11721-123 Issued in WI
Practice address
2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Phone
(920) 457-4461
NPI assigned
Jan 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 129206-121 WI
Clinical Social Worker 1041C0700X 11721-123 WI Primary

Addresses

Primary practice location

2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

E7475 Rawhide Rd
New London, WI 54961-9025
Phone (877) 300-9101

Other identifiers 1

IdentifierTypeStateIssuer
100225398MedicaidWI

Other names 1

  • Megan Krueger Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mketter414644@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20241203000667 WI Practitioner - Clinical Social Worker 3779016142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Phone (920) 457-4461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129206-121WIMDSocial Worker
11721-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 30, 2024 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 30, 2024 Accepting new patients
Rawhide Inc. PastSince Jan 1, 2023 Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

Interoperability endpoints

  • Direct secure messaging: mketter414644@direct.myadvocateaurora.org
  • Direct secure messaging: megan.ketter@25254901.chartlogic.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1851006761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 KOHLER MEMORIAL DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813129",
            "telephone_number": "920-457-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "E7475 Rawhide Rd",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "WI",
            "postal_code": "549619025",
            "country_code": "US",
            "telephone_number": "877-300-9101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTER",
        "first_name": "MEGAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "129206-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11721-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100225398",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mketter414644@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2414 Kohler Memorial Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2414 Kohler Memorial Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "KRUEGER",
            "credential": "APSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.