Individual provider Active NPI

Jessica L Serwe, DC

  • Chiropractor
  • Fond Du Lac, WI
National Provider Identifier
1063589505
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4174-012 Issued in WI
Practice address
976 E Johnson St
Suite 900
Fond Du Lac, WI 54935-9746
Phone
(920) 907-1700
Fax
(920) 907-1708
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4174-012 WI Primary

Addresses

Primary practice location

976 E Johnson St
Suite 900
Fond Du Lac, WI 54935-9746

Mailing address

976 E Johnson St
Suite 900
Fond Du Lac, WI 54935-9746
Phone (920) 907-1700

Other identifiers 1

IdentifierTypeStateIssuer
38185900MedicaidWI

Other names 1

  • Dr. Jessica L Rodriguez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000136 WI Practitioner - Chiropractic 5294757837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

976 E Johnson St
Suite 900
Fond Du Lac, WI 54935-9747
Phone (920) 907-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4174-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fond Du Lac Chiropractic & Wellness Center LLC Chiropractor CurrentSince Nov 15, 2008 Accepting new patients
Ideal Chiropractic of Fond Du Lac LLC Chiropractor PastSince Dec 15, 2005 Accepting new patients

Locations

976 E Johnson St
Fond du Lac, WI 54935
Phone (920) 907-1700

976 E Johnson St
Ste 900
Fond du Lac, WI 54935
Phone (920) 539-8289

Organizations & group practices 2

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1063589505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 E JOHNSON ST",
            "address_2": "SUITE 900",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549359746",
            "telephone_number": "920-907-1700",
            "fax_number": "920-907-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 E JOHNSON ST",
            "address_2": "SUITE 900",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549359746",
            "telephone_number": "920-907-1700",
            "fax_number": "920-907-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERWE",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4174-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38185900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "RODRIGUEZ",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.