Jerry Lee Halverson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

43851 Issued in WI

Practice address

34700 Valley Rd
Oconomowoc, WI 53066-4500

Phone

(262) 646-4411

Fax

(262) 646-1076

NPI assigned

Mar 22, 2006

Last updated

May 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Rogers Memorial Hospital Incorporated

  dba Rogers Behavioral Health

  • Psychiatric Hospital
  • Oconomowoc, WI
  • NPI 1053329581

  Corporate Director, Corporate Officer

  CMS ownership

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.

• Rogers Memorial Hospital Incorporated

  dba Rogers Behavioral Health

  • Psychiatric Hospital
  • Oconomowoc, WI
  • NPI 1053329581
  Medicare reassignment NPD
• Rogers Behavioral Health - Wisconsin SC

  dba Rogers Behavioral Health Practice - Wisconsin SC

  • Psychiatry Physician
  • Oconomowoc, WI
  • NPI 1699524751

  Addiction Medicine

  NPD
• County of Milwaukee

  • Psychiatry Physician
  • Milwaukee, WI
  • NPI 1831256353
  NPD (past)
• Rogers Behavioral Health - Georgia Inc

  dba Rogers Behavioral Health

  • Clinic/Center
  • Sandy Springs, GA
  • NPI 1700410131
  NPD (past)
• Rogers Behavioral Health - Tennessee Inc

  dba Rogers Behavioral Health

  • Clinic/Center
  • Brentwood, TN
  • NPI 1548049463
  NPD (past)
• Rogers Behavioral Health Practice - Tennessee, P.C.

  • Psychiatry Physician
  • Brentwood, TN
  • NPI 1811776727

  Addiction Medicine

  NPD (past)
• Rogers Behavioral Health Practice PC

  dba Rogers Behavioral Health Practice - Georgia, P.C.

  • Psychiatry Physician
  • Sandy Springs, GA
  • NPI 1669006003

  Addiction Medicine

  NPD (past)
• Rogers Behavioral Health, Inc.

  dba Rogers Behavioral Health

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1538700471
  NPD (past)
• Rogers Behavioral Health, Inc.

  dba Rogers Behavioral Health

  • Clinic/Center
  • San Diego, CA
  • NPI 1972065241
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1952360422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411",
            "fax_number": "262-646-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411",
            "fax_number": "262-646-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "JERRY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "WI",
            "license": "43851",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "43851",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "WI",
            "license": "43851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Gunderson
• Alecia Guttilla, CLD
• Melissa Hackbarth, LPC
• Bethany Hafenstein-Riege
• Samuel Hall, MD
• Elizabeth A Hamlin, MD
• Kim Hannan, LPC
• Richard Morris Hansen, MD
• Bridgette Marie Hanson, RN
• James Joseph Harper, M.D.

• Psychiatry Physician in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.