Active NPI
Jessica Hoberg, CPNP
- Pediatric Nurse Practitioner
- West Allis, WI
National Provider Identifier
1174627400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 246333
- Practice address
- 11101 W Lincoln Ave
Rogers Memorial Hospital
West Allis, WI 53227 - Phone
- (414) 327-3000
- NPI assigned
- Sep 8, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 246333 | WI | Primary |
Addresses
Primary practice location
11101 W Lincoln Ave
Rogers Memorial Hospital
West Allis, WI 53227
Mailing address
3630 N Hickory Lane
Oconomowoc, WI 53066
Phone (262) 646-1338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41195500 | Medicaid | WI |
Other names 1
- Jessica Witt
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)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 246333 | WI | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1174627400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3630 N HICKORY LANE",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "53066",
"telephone_number": "262-646-1338",
"fax_number": "262-646-7067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11101 W LINCOLN AVE",
"address_2": "ROGERS MEMORIAL HOSPITAL",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "53227",
"telephone_number": "414-327-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOBERG",
"first_name": "JESSICA",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-08",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WI",
"license": "246333",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41195500",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "WITT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.