DENNIS DEAN ELMERGREEN, Psy. D. — NPI 1922172675 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1922172675

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103TF0000X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Family

Box 32 Service Location & ZIP+4

W12802 COUNTY ROAD A, BOWLER, WI, 54416-9551

✓ 9-Digit EDI 837 ZIP+4 (54416-9551)

Practice Phone & Referral Fax

(715) 793-4144

Fax: (715) 793-4120

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1922172675 (DENNIS DEAN ELMERGREEN, Psy. D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1922172675` (NPI-1 Individual Practitioner)
Provider / Legal Name	DENNIS DEAN ELMERGREEN, Psy. D.
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Family NUCC Code: `103TF0000X` (Psychologist, Family)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	W12802 COUNTY ROAD A, BOWLER, WI, 54416-9551
Practice Telephone / Fax	Tel: (715) 793-4144 \| Fax: (715) 793-4120
Administrative Mailing Address	3911 CRESTWOOD DR, WAUSAU, WI, 54403-2399
Enumeration & Last Sync	Enumerated: 2006-11-17 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

W12802 COUNTY ROAD A, BOWLER, WI, 54416-9551

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Plain-English Taxonomy & CMS Crosswalk (103TF0000X)

What Does Taxonomy Code 103TF0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TF0000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Family"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, Family for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DENNIS DEAN ELMERGREEN, Psy. D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103TF0000X` — Psychologist, Family Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Family	State: WI \| License: `1260-057` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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DENNIS DEAN ELMERGREEN, Psy. D. (NPI #1922172675)