Individual provider Active NPI

Jantina R Vonk, MD

  • Psychiatry Physician
  • Madison, WI
National Provider Identifier
1396798914
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34728 Issued in WI
Practice address
625 W Washington Ave
Madison, WI 53703-2637
Phone
(608) 280-2510
Fax
(608) 280-2426
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34728 WI Primary

Addresses

Primary practice location

625 W Washington Ave
Madison, WI 53703-2637

Mailing address

1425 Red Cloud Lane
Madison, WI 53704
Phone (608) 245-1665

Other identifiers 1

IdentifierTypeStateIssuer
31970500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Human Medicine, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6302 Odana Rd
Suite 302
Madison, WI 53719-1162

PO Box
Suite 1649
Janesville, WI 53547-1649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34728WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Centers, Inc. CurrentSince May 17, 2012 Accepting new patients
Collaborative Solutions in Psychiatry, SC CurrentSince Jan 1, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 1, 2014 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 1, 2014 Accepting new patients
Access Community Health Centers, Inc. CurrentSince May 17, 2012 Accepting new patients
Hhu Xtra Care Inc PastSince Sep 2, 2009 Accepting new patients
Horizon Healthcare, Inc Past Accepting new patients

Locations

626 Monroe St
Beaver Dam, WI 53916
Phone (920) 885-1790

2202 S Park St
Madison, WI 53713
Phone (608) 443-5480

2901 W Beltline Hwy
Ste 120
Madison, WI 53713
Phone (608) 443-5500

6001 Research Park Blvd
Madison, WI 53719
Phone (608) 232-3171

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

25 Kessel Ct
Ste 105
Madison, WI 53711
Phone (608) 280-2636

5100 Eastpark Blvd
Madison, WI 53718
Phone (608) 222-8232

7818 Big Sky Dr
Ste 103
Madison, WI 53719
Phone (608) 203-6267

6515 Grand Teton Plz
Ste 220
Madison, WI 53719
Phone (608) 713-9898

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396798914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 RED CLOUD LANE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53704",
            "telephone_number": "608-245-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637",
            "telephone_number": "608-280-2510",
            "fax_number": "608-280-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONK",
        "first_name": "JANTINA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "34728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31970500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.