Active NPI
Jennifer M Chevalier, MD
- Pediatrics Physician
- Brookfield, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 42630-20
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003867409 | Medicaid | WI |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051109001117 | WI | Practitioner - Emergency Medicine | 1153349998 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42630-20 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Current | 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.