Jessica R Schroeder, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2881-057 Issued in WI

Practice address

1000 W Wisconsin Ave Ste 1
Appleton, WI 54914-3551

Phone

(920) 257-4601

Fax

(920) 257-4603

NPI assigned

Aug 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthy Connections, LLCGroup PAC ID 5698957447, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthy Connections, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dale, WI
  • NPI 1699094912
  Medicare reassignment Care Compare group NPD Authorized official
• Innovative Counseling Inc

  • Community/Behavioral Health Agency
  • Green Bay, WI
  • NPI 1093869588
  NPD (past)

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1316130404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W WISCONSIN AVE STE 1",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143551",
            "telephone_number": "920-257-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W WISCONSIN AVE STE 1",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143551",
            "telephone_number": "920-257-4601",
            "fax_number": "920-257-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2881-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316130404",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Schreiber
• Ronald T Schreiber, MD
• Paul M Schroeder-Haag, LPC-IT, SAC-IT
• Amber S Schroeder, PTA
• Grant Schroeder, PT, DPT
• Julie L Schroeder, M.S. CCC-SLP
• Nicole Schroeder
• Norman J Schroeder II, MD
• Patricia G Schroeder, NP-C
• Regina Suzanne Schroeder, CST

• Psychologist in Appleton, WI
• Providers in Appleton, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.