Individual provider Active NPI

Jessica A Grzybowski, MS

  • Genetic Counselor (M.S.)
  • Milwaukee, WI
National Provider Identifier
1174766810
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
Practice address
9200 W Wisconsin Ave
Clincal Cancer Center, Quality of Life Clinic
Milwaukee, WI 53226-3522
Phone
(414) 805-9087
Fax
(414) 805-0970
NPI assigned
Apr 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 247000012 IL
Genetic Counselor (M.S.) 170300000X WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Clincal Cancer Center, Quality of Life Clinic
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Clincal Cancer Center, Quality of Life Clinic
Milwaukee, WI 53226-3522
Phone (414) 805-9087

Other names 1

  • Jessica A Wehr 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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
247000012ILMDGenetic Counselor (M.S.)

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1174766810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "CLINCAL CANCER CENTER, QUALITY OF LIFE CLINIC",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-9087",
            "fax_number": "414-805-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "CLINCAL CANCER CENTER, QUALITY OF LIFE CLINIC",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-9087",
            "fax_number": "414-805-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZYBOWSKI",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "IL",
            "license": "247000012",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WEHR",
            "middle_name": "A",
            "credential": "MS",
            "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 Feb 27, 2013; 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.