Active NPI
Jessica Kathleen Mattson, RN
- Registered Nurse
- Cochrane, WI
National Provider Identifier
1336764570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 253632-30
- Practice address
- 107 Wisconsin Ave
Cochrane, WI 54622-7311 - Phone
- (507) 730-1453
- NPI assigned
- Jun 13, 2020
- Last updated
- Jun 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 253632-30 | WI | Primary |
Addresses
Primary practice location
107 Wisconsin Ave
Cochrane, WI 54622-7311
Mailing address
215 North St
Fountain City, WI 54629-8253
Phone (320) 223-5767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 253632-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592006400000",
"number": "1336764570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 NORTH ST",
"city": "FOUNTAIN CITY",
"state": "WI",
"postal_code": "546298253",
"telephone_number": "320-223-5767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WISCONSIN AVE",
"city": "COCHRANE",
"state": "WI",
"postal_code": "546227311",
"telephone_number": "507-730-1453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTSON",
"first_name": "JESSICA",
"middle_name": "KATHLEEN",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-13",
"last_updated": "2020-06-13",
"certification_date": "2020-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "253632-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cochrane, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.