Individual provider Active NPI

Jazmyn Weinzatl

  • Professional Counselor
  • Oshkosh, WI
National Provider Identifier
1275908675
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7237-125 Issued in WI
Practice address
220 Washington Ave
Oshkosh, WI 54901-5030
Phone
(920) 236-4700
Fax
(920) 236-1157
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2783-226 WI
Professional Counselor 101YP2500X 7237-125 WI Primary

Addresses

Primary practice location

220 Washington Ave
Oshkosh, WI 54901-5030

Mailing address

220 Washington Ave
Oshkosh, WI 54901-5030
Phone (920) 236-4700

Other names 1

  • Jazmyn Wilbanks Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108000507 WI Practitioner - Mental Health Counselor 5991153314 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2783-226WIMDMental Health Counselor
7237-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Winnebago County CurrentSince Jan 1, 2024 Accepting new patients
County of Winnebago Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

211 N Commercial St
Neenah, WI 54956
Phone (920) 236-4600

220 Washington Ave
Oshkosh, WI 54901
Phone (920) 236-4700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1275908675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 WASHINGTON AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549015030",
            "telephone_number": "920-236-4700",
            "fax_number": "920-236-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 WASHINGTON AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549015030",
            "telephone_number": "920-236-4700",
            "fax_number": "920-236-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINZATL",
        "first_name": "JAZMYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2783-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7237-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAZMYN",
            "last_name": "WILBANKS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.