Individual provider Active NPI

Jamie J Wolf, APNP

  • Family Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1366854069
Registry record updated May 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5762 Issued in WI
Practice address
725 American Ave
725 American Ave Neuroscience Center
Waukesha, WI 53188-5031
Phone
(262) 928-8668
Fax
(262) 928-7843
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5762 WI Primary

Addresses

Primary practice location

725 American Ave
725 American Ave Neuroscience Center
Waukesha, WI 53188-5031

Mailing address

725 American Ave
Neuroscience Center Prohealth Care
Waukesha, WI 53188-5031
Phone (262) 928-8668

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140612001124 WI Practitioner - Nurse Practitioner 3274757224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1185 Corporate Ctr Dr
Oconomowoc, WI 53066-4888

721 American Ave
Waukesha, WI 53188-5071

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5762WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc CurrentSince Jul 1, 2014 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Jul 1, 2014 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

1185 Corporate Center Dr
Ste 215
Oconomowoc, WI 53066
Phone (262) 928-8440

721 American Ave
Ste 501
Waukesha, WI 53188
Phone (262) 928-2396

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

721 American Ave
Ste 108
Waukesha, WI 53188
Phone (262) 928-2570

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1366854069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "address_2": "NEUROSCIENCE CENTER PROHEALTH CARE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-8668",
            "fax_number": "262-928-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "address_2": "725 AMERICAN AVE NEUROSCIENCE CENTER",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-8668",
            "fax_number": "262-928-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "JAMIE",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.