Active NPI
Jessica Lynn Mickevicius, PHARMD
- Pharmacist
- Pewaukee, WI
National Provider Identifier
1093545279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2271340
- Practice address
- 411 Pewaukee Rd
Pewaukee, WI 53072-5886 - Phone
- (262) 695-2878
- NPI assigned
- Aug 3, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2271340 | WI | Primary |
Addresses
Primary practice location
411 Pewaukee Rd
Pewaukee, WI 53072-5886
Mailing address
13405 W Burleigh Rd Apt 103
Brookfield, WI 53005-3053
Phone (262) 853-1763
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2271340 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761523200000",
"number": "1093545279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13405 W BURLEIGH RD APT 103",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530053053",
"telephone_number": "262-853-1763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 PEWAUKEE RD",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530725886",
"telephone_number": "262-695-2878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKEVICIUS",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-03",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "2271340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.