KELLY THOMACK
NPI 1750796488
Counselor - Professional in Appleton, WI
NPI Status: Active since June 20, 2014
Contact Information
5471 W WATERFORD LN
APPLETON, WI
ZIP 54913
Phone: (920) 731-7445
Fax: (920) 731-7490
- Individual
- Female
- Counselor
- Professional
- Accepts Insurance
About KELLY THOMACK
This page provides the complete NPI Profile along with additional information for Kelly Thomack, a provider established in Appleton, Wisconsin with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1750796488 assigned on June 2014. The practitioner's primary taxonomy code is 101YP2500X with license number 5455-125 (WI). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1750796488
- Provider Name
- KELLY THOMACK
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 5471 W WATERFORD LN APPLETON, WI 54913
- Location Phone
- (920) 731-7445
- Location Fax
- (920) 731-7490
- Mailing Address
- 1835 E EDGEWOOD DR STE 105-540 APPLETON, WI 54913
- Mailing Phone
- (920) 731-7445
- Mailing Fax
- (920) 731-7490
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-20-2014
- Last Update Date
- 07-15-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 5455-125
- License State
- WI
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
- CGHC Bronze Standard $7500 - Envision Network - EPO
- CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
- CGHC Catastrophic $9200 - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
- CGHC Gold $3000 - Envision Network - EPO
- CGHC Gold $3000 - Envision Network (Vision Exam) - EPO
- CGHC Gold Standard $1500 - Envision Network - EPO
- CGHC Gold Standard $1500 - Envision Network (Vision Exam) - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver Standard $5000 - Envision Network - EPO
- CGHC Silver Standard $5000 - Envision Network (Vision Exam) - EPO
- Atlas $1,000 Gold - PPO
- Atlas $1,500 Standard Gold - PPO
- Atlas $2,650 Plus Silver - PPO
- Atlas $3,500 HSA Silver - PPO
- Atlas $5,000 Standard Silver - PPO
- Atlas $6,500 Plus Bronze - PPO
- Atlas $7,500 Standard Bronze - PPO
- Atlas $8,200 HSA Bronze - PPO
- Atlas $9,200 Catastrophic - PPO
- Robin Oak $1,000 Gold - PPO
- Robin Oak $1,500 Standard Gold - PPO
- Robin Select $2,800 Plus Silver - PPO
- Robin Select $3,500 HSA Silver - PPO
- Robin Select $5,000 Standard Silver - PPO
- Robin Select $6,500 Plus Bronze - PPO
- Robin Select $7,500 Standard Bronze - PPO
- Robin Select $8,200 HSA Bronze - PPO
- Robin Select $9,200 Catastrophic - PPO
- Engage by Medica Bronze HSA - EPO
- Engage by Medica Bronze Share - EPO
- Engage by Medica Expanded Bronze Standard - EPO
- Engage by Medica Gold $0 Copay PCP Visits - EPO
- Engage by Medica Gold Share - EPO
- Engage by Medica Gold Standard - EPO
- Engage by Medica Silver $0 Copay PCP Visits - EPO
- Engage by Medica Silver Share - EPO
- Engage by Medica Silver Standard - EPO
- Essentia Choice Care with Medica Bronze HSA - EPO
- Essentia Choice Care with Medica Bronze Share - EPO
- Essentia Choice Care with Medica Expanded Bronze Standard - EPO
- Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
- Essentia Choice Care with Medica Gold Share - EPO
- Essentia Choice Care with Medica Gold Standard - EPO
- Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
- Essentia Choice Care with Medica Silver Share - EPO
- Essentia Choice Care with Medica Silver Standard - EPO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Gold 8 with Rx Copay - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 1 with Rx Copay and Adult Vision Services - HMO
- Silver 12 with first 4 free PCP or MH visits - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold Essential + 3Free PCP Visits - HMO
- Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Silver - HMO
- Prestige Silver Essential + 3 Free PCP Visits - HMO
- Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Signature Prestige Bronze $0 Deductible - HMO
- Signature Prestige Bronze $0 Deductible + Dental + Vision - HMO
- Bronze Classic - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Secure - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite - EPO
- Silver Simple Chronic Care CKM - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- Premier $1,500 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,100 HDHP - HMO
- Premier $5,000 - 40% - HMO
- Premier $6,200 HDHP - HMO
- Premier $7,500 - HMO
- Premier $9,200 - HMO
- Premier Protection - HMO
- Premier HMO $1,500 - 30% - HMO
- Premier HMO $2,500 - 20% Copay - HMO
- Premier HMO $3,300 - 30% HDHP - HMO
- Premier HMO $3,500 - 30% - HMO
- Premier HMO $3,500 HDHP - HMO
- Premier HMO $4,000 - 20% HDHP - HMO
- Premier HMO $5,000 - 20% HDHP - HMO
- Premier HMO $5,500 - 30% Copay - HMO
- Premier HMO $7,050 HDHP - HMO
- Premier HMO $750 - 10% - HMO
- Premier HMO $9,100 - HMO
- Premier POS $1,500 - 30% - POS
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care) - HMO
- UHC Bronze Value (Rx Copay, No Referrals) - HMO
- UHC Bronze Value HSA (No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 7 | 9 | 6 | 4 | 8 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 14 | 9 | 12 | 4 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 4 + 9 + 1 + 2 + 4 + 1 + 6 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1750796488 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1235634510 | KRISTIN KNOTT Individual | Radiology (Body Imaging) | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1215921127 | KAREN W BEUTLER MD Individual | Family Medicine | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1558308577 | IRIS N TORRES MD Individual | Family Medicine | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1558423517 | JOANNE M STEPHANY NP Individual | Nurse Practitioner | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1730452400 | SUSAN HAYDAR PHD Individual | Psychologist (Clinical) | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1730750381 | ISIAH M SIEMERS Individual | Social Worker (Clinical) | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1134895261 | MARIA E CRIPE APNP Individual | Nurse Practitioner (Family) | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1417630211 | AVERY MADISON HARTER NP Individual | Nurse Practitioner | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1447870910 | PARTNERSHIP COMMUNITY HEALTH CENTER, INC Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1962496760 | JOSE M LEIVA MD Individual | Family Medicine | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
| 1003449596 | VICKI LYNN AHO Individual | Registered Nurse (Addiction (Substance Use Disorder)) | 5471 W WATERFORD LN APPLETON, WI 54913 (920) 731-7445 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750796488, enumerated in the NPI registry as an "individual" on June 20, 2014
The provider is located at 5471 W Waterford Ln Appleton, Wi 54913 and the phone number is (920) 731-7445
The provider's speciality is Counselor with taxonomy code 101YP2500X with a focus in Professional
The provider might be accepting Accepts: Aetna CVS Health, Anthem Blue Cross and Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on June 20, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.