Individual provider Active NPI

Jessica Keyzer

  • Clinical Social Worker
  • Wisconsin Rapids, WI
National Provider Identifier
1912527102
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9420-123 Issued in WI
Practice address
111 W Jackson St
Wisconsin Rapids, WI 54495-2702
Phone
(715) 421-8800
NPI assigned
Apr 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9420-123 WI Primary

Addresses

Primary practice location

111 W Jackson St
Wisconsin Rapids, WI 54495-2702

Mailing address

111 W Jackson St
Wisconsin Rapids, WI 54495-2702
Phone (715) 421-8845

Other practice location 1

1600 N Chestnut Ave
Marshfield, WI 54449-1449
Phone (715) 421-8800

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
I20200423002536 WI Practitioner - Clinical Social Worker 7113357674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of WoodGroup PAC ID 3476554692, 15 clinicians

Practice addresses (Care Compare)

111 W Jackson St
Wisconsin Rapids, WI 54495-2702
Phone (715) 421-8820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9420-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Wood CurrentSince Apr 20, 2020 Accepting new patients
County of Wood CurrentSince Apr 20, 2020 Accepting new patients

Locations

1600 N Chestnut Ave
Marshfield, WI 54449
Phone (715) 384-2188

111 W Jackson St
Wisconsin Rapids, WI 54495
Phone (715) 421-8820

Organizations & group practices 2

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": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1912527102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W JACKSON ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544952702",
            "telephone_number": "715-421-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JACKSON ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544952702",
            "telephone_number": "715-421-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Chestnut Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544491449",
            "country_code": "US",
            "telephone_number": "715-421-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEYZER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-17",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9420-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.