Therese L. Jaeckle, MSN, APNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3319-033 Issued in WI

Practice address

W62N248 Washington Ave
Cedarburg, WI 53012-2768

Phone

(262) 375-1116

NPI assigned

Dec 19, 2007

Last updated

Feb 4, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Therese Ann Lupone Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psych Med Management LLCGroup PAC ID 5294053443, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psych Med Management LLC

  • Community/Behavioral Health Agency
  • Thiensville, WI
  • NPI 1376941963
  Medicare reassignment Care Compare group NPD Authorized official
• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  NPD (past)
• Aurora Quick Care, LLC

  • Nurse Practitioner
  • Mequon, WI
  • NPI 1609820729
  NPD (past)
• Comprehensive Clinical and Consulting Services, Inc

  • Psychologist
  • Milwaukee, WI
  • NPI 1487830790
  NPD (past)
• Northshore Clinic & Consultants, Inc.

  • Community/Behavioral Health Agency
  • Cedarburg, WI
  • NPI 1720201163
  NPD (past)
• Women & Families' Psychotherapy Resources, Inc

  • Mental Health Counselor
  • Waukesha, WI
  • NPI 1801818950
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1063696516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 N 143RD ST",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530051664",
            "telephone_number": "262-781-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W62N248 WASHINGTON AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122768",
            "telephone_number": "262-375-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECKLE",
        "first_name": "THERESE",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "MSN,  APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "3319-033",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "3319-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESE",
            "last_name": "LUPONE",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "MSN, APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hope's Chariot, Inc.
• Megan Hucko
• Muhammad Ibrahim, RPH
• Ideal Physical Therapy LLC
• Daniel Jablonski, MD
• Jaime D. Cabatingan, M.D.,S.C.
• Jaime D. Cabatingan, M.D.,S.C.
• Kimberly Marie Janecek, APNP
• Janice Alexander RN, MD,SC
• John Richard Jankowski, R.PH.

• Psychiatric/Mental Health Nurse Practitioner in Cedarburg, WI
• Providers in Cedarburg, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.
• 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.