Individual provider Active NPI

Adrienne L Johnson, PHD

  • Psychologist
  • Fitchburg, WI
National Provider Identifier
1962163378
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3922-57 Issued in WI
Practice address
5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376
Phone
(608) 263-7740
Fax
(608) 262-6048
NPI assigned
Jan 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3922-57 WI Primary

Addresses

Primary practice location

5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other names 1

  • Adrienne L Lidgard Former name

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
I20220302001185 WI Practitioner - Clinical Psychologist 6305230657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376
Phone (608) 274-5300

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Mar 1, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Mar 1, 2022 Accepting new patients

Locations

5543 E Cheryl Pkwy
Fitchburg, WI 53711
Phone (608) 263-7740

5249 E Terrace Dr
Madison, WI 53718
Phone (608) 222-9777

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

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": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1962163378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5543 E CHERYL PKWY",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115376",
            "telephone_number": "608-263-7740",
            "fax_number": "608-262-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ADRIENNE",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3922-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "LIDGARD",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.