Jackie Marie Rietz, APNP, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9354-33 Issued in WI

Practice address

413 N 17TH Ave Ste 100
Wausau, WI 54401-4287

Phone

(715) 298-4454

Fax

(715) 802-8568

NPI assigned

Jul 19, 2019

Last updated

May 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jackie Marie Corvino Former name

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aspirus Stevens Point Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1538112230
  Medicare reassignment NPD
• Sleep Apnea Care and Wellness LLC

  dba Koala Center for Sleep Disorders

  • Customized Equipment (DME)
  • Wausau, WI
  • NPI 1114342847
  Medicare reassignment NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  dba Aspirus Behavioral Health Clinic - Stevens Point - Prentice St

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1679706022
  NPD
• Sleep Apnea Care and Wellness, LLC

  dba Koala Center for Sleep Disorders WI-4

  • Durable Medical Equipment & Medical Supplies
  • Plover, WI
  • NPI 1689106387
  NPD

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1326691254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11825 STATE ROUTE 40 STE 100",
            "city": "DUNLAP",
            "state": "IL",
            "postal_code": "615258842",
            "telephone_number": "715-892-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N 17TH AVE STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014287",
            "telephone_number": "715-298-4454",
            "fax_number": "715-802-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIETZ",
        "first_name": "JACKIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9354-33",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9354-33",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "CORVINO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Howard Andrew Rice, P.T.
• Susan M. Rice, P.T.
• Mark A Richetto, MD
• Morgan Lynn Rieckmann
• Amy Dawn Riegert, BSN RN SANE-A
• James Albert Rindt Jr., MD
• Cole Ringer
• Colleen Marie Rinken, M.ED.
• Daljeet Rishi, MD
• Shailly Rishi, PA

• Nurse Practitioner in Wausau, WI
• Providers in Wausau, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.