Brock Davis Vern Schultz, LPC-IT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3887-226 Issued in WI

Practice address

1955 W Broadway Ste 104
Monona, WI 53713-3700

Phone

(608) 395-1795

NPI assigned

Feb 23, 2022

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

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

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Generations IncGroup PAC ID 5294254363, 2 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.

• Our Generations Inc.

  • Professional Counselor
  • Monona, WI
  • NPI 1609520204
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1902552417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 W BROADWAY STE 104",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537133700",
            "telephone_number": "608-395-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W BROADWAY STE 104",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537133700",
            "telephone_number": "608-395-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "BROCK",
        "middle_name": "DAVIS VERN",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3887-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Kaye Schmidt
• Christina Schmoker
• Heather E Schneider, LPC
• Mary T Schoenherr, RN
• Jacob Schuldies, LCSW
• Richard D. Schwichtenberg, LCSW
• Scott L Fenton, PSYD, LLC
• Scott White Chiropractic LLC
• Elizabeth Seeliger
• Doris A Seitz, R.PH.

• Professional Counselor in Monona, WI
• Providers in Monona, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.