Individual provider Active NPI

Jennifer M Chevalier, MD

  • Pediatrics Physician
  • Brookfield, WI
National Provider Identifier
1003867409
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
42630-20 Issued in WI
Practice address
13950 W Capitol Dr Ste 200
Brookfield, WI 53005-2441
Phone
(262) 781-3065
Fax
(262) 781-3835
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 42630 WI
Pediatrics Physician 208000000X 42630-20 WI Primary

Addresses

Primary practice location

13950 W Capitol Dr Ste 200
Brookfield, WI 53005-2441

Mailing address

9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615

Other practice location 1

9000 W Wisconsin Ave
Pediatric Emergency Medicine
Milwaukee, WI 53226-4874
Phone (414) 266-2625

Other identifiers 1

IdentifierTypeStateIssuer
1003867409MedicaidWI

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109001117 WI Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 1153349998 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42630-20WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Mar 31, 2017 Accepting new patients
Childrens Hospital of Wisconsin, Inc. Pediatrics Past Accepting new patients
Centegra Primary Care, LLC Pediatrics Past Accepting new patients
Children'S Medical Group Pediatrics Past Accepting new patients

Locations

9000 W Wisconsin Ave
#958
Wauwatosa, WI 53226
Phone (414) 266-7615

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: jchevalier5878@direct.chw.org

Organizations & group practices 4

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1003867409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 W CAPITOL DR STE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052441",
            "telephone_number": "262-781-3065",
            "fax_number": "262-781-3835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 W Wisconsin Ave",
            "address_2": "Pediatric Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264874",
            "country_code": "US",
            "telephone_number": "414-266-2625",
            "fax_number": "414-266-2635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEVALIER",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "WI",
            "license": "42630",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "42630-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003867409",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.