Terry R Kaddatz, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2013 Issued in WI

Practice address

3398 East Maria Drive
Stevens Point, WI 54481

Phone

(715) 341-7441

NPI assigned

Feb 21, 2007

Last updated

May 23, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 26, 2018 through Jun 26, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Central Wisconsin Counseling Associates, LLC

  • Clinical Social Worker
  • Wisconsin Rapids, WI
  • NPI 1316012396
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1972648251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ILLINOIS AVENUE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3398 EAST MARIA DRIVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-341-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADDATZ",
        "first_name": "TERRY",
        "middle_name": "R",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39119200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane P. Jones, PH.D.
• Kaitlyn Jones, PHARMD
• Mark Allen Jordan, MD
• Rebecca Jorgensen, DNP
• Daniel Stephen Judd, DO
• Alexis Kammers
• Richard Wayne Kania, RPH
• Audrey C Kast, PHD
• Adrienne N Kaster, PT
• Dennis Kaster, PT

• Psychologist in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.