Renee M. Jacquette, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2640-12 Issued in WI

Practice address

17040 W Greenfield Ave Ste 3
Brookfield, WI 53005-6899

Phone

(414) 930-2363

NPI assigned

Nov 17, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1990

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Premier Chiropractic & Wellness, LLC

  • Chiropractor
  • Brookfield, WI
  • NPI 1902310279
  Medicare reassignment Authorized official
• Jacquette Chiropractic SC

  • Chiropractor
  • Brookfield, WI
  • NPI 1861565814
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1083787766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17040 W GREENFIELD AVE STE 3",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056899",
            "telephone_number": "414-930-2363",
            "fax_number": "414-930-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17040 W GREENFIELD AVE STE 3",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056899",
            "telephone_number": "414-930-2363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13740 W Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530052407",
            "country_code": "US",
            "telephone_number": "262-781-3332",
            "fax_number": "262-781-6477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACQUETTE",
        "first_name": "RENEE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2640-12",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38851400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Jacobs
• Megan Jane Jacobs, M.S. CCC-SLP
• Jacquette Chiropractic SC
• Mark R Jacquette, D.C.
• Raymond Jacquette
• Erin Jaeger
• Thomas Jahnke, DDS
• Kate Jahnz, PTA
• Amber Lynn Jakubek
• James a Stadler, MD, SC

• Chiropractor in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.