Individual provider Active NPI

Jewel E Schneider, APNP

  • Nurse Practitioner
  • Watertown, WI
National Provider Identifier
1225579253
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7570 Issued in WI
Practice address
109 Air Park Dr
Watertown, WI 53094-7400
Phone
(920) 262-7444
NPI assigned
Mar 9, 2017
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7570 WI Primary

Addresses

Primary practice location

109 Air Park Dr
Watertown, WI 53094-7400

Mailing address

109 Air Park Dr
Watertown, WI 53094-7400
Phone (920) 262-7444

Other practice location 1

945 N 12th St
Ste 2110
Milwaukee, WI 53233
Phone (414) 219-6809

Other practice location 2

945 N 12th St
Ste 2110
Milwaukee, WI 53233
Phone (414) 219-6809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170327000193 WI Practitioner - Nurse Practitioner 1850676289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

109 Air Park Dr
Watertown, WI 53094-7400
Phone (262) 928-5100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7570WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Jan 15, 2018 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

2205 N Calhoun Rd
Brookfield, WI 53005
Phone (262) 782-3120

945 N 12th St
Ste 2110
Milwaukee, WI 53233
Phone (414) 219-6809

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1225579253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 AIR PARK DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530947400",
            "telephone_number": "920-262-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 AIR PARK DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530947400",
            "telephone_number": "920-262-7444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "945 N 12th St",
            "address_2": "Ste 2110",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53233",
            "country_code": "US",
            "telephone_number": "414-219-6809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 N 12th St",
            "address_2": "Ste 2110",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53233",
            "country_code": "US",
            "telephone_number": "414-219-6809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "JEWEL",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.