Jourdyn Leigh Koebe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4400-23 Issued in WI

Practice address

333 Pine Ridge Blvd
Wausau, WI 54401

Phone

(715) 847-2160

NPI assigned

Jun 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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.

• Aspirus Wausau Hospital, Inc.

  dba Aspirus Wausau Hospital Hospitalists

  • Clinic/Center
  • Wausau, WI
  • NPI 1922321140
  Medicare reassignment
• Aspirus Wausau Hospital, Inc.

  dba Aspirus Palliative Medicine- Wisconsin

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wausau, WI
  • NPI 1225905102
  NPD
• Aspirus Wausau Hospital, Inc.

  • General Acute Care Hospital
  • Wausau, WI
  • NPI 1558363986
  NPD

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1316431406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E 9TH ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544521660",
            "telephone_number": "715-218-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-847-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEBE",
        "first_name": "JOURDYN",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4400-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fame Knipp, PHARMD
• Jacklyn A Knoll, PA-C
• Brittany Marie Knox
• Krista Kocha
• Kochas Interim Healthcare Inc (Interim Healthcare of Wausau)
• Cynthia M. Koehler, PT
• Aaron Koeller, SAC-IT
• Bradley Neil Koenig, RN
• Lindsay A. Koepke, PT
• Thomas A Koepke, MD

• Physician Assistant in Wausau, WI
• Providers in Wausau, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.