Individual provider Active NPI

Sarah Elizabeth Juckem

  • Pediatric Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1134979453
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
14462-33 Issued in WI
Practice address
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone
(414) 337-7050
Fax
(414) 337-7020
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 14462-33 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874

Mailing address

2174 N 58TH St
Milwaukee, WI 53208-1034
Phone (715) 513-0836

Other names 1

  • Sarah Elizabeth Miller Former name

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

State licenses

LicenseStateTypeSpecialty
14462-33WIMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: sjuckem131827@direct.chw.org

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1134979453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2174 N 58TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081034",
            "telephone_number": "715-513-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-337-7050",
            "fax_number": "414-337-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUCKEM",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "14462-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "MILLER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.