Active NPI
Matthew Jeffrey Schommer
- Registered Nurse
- Kaukauna, WI
National Provider Identifier
1417822339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 221945-30
- Practice address
- 875 Gertrude St
Kaukauna, WI 54130-1128 - Phone
- (715) 892-6761
- NPI assigned
- Oct 9, 2025
- Sex
- Male
- 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 | 221945-30 | WI | Primary |
Addresses
Primary practice location
875 Gertrude St
Kaukauna, WI 54130-1128
Mailing address
875 Gertrude St
Kaukauna, WI 54130-1128
Phone (715) 892-6761
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221945-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759968000000",
"number": "1417822339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 GERTRUDE ST",
"city": "KAUKAUNA",
"state": "WI",
"postal_code": "541301128",
"telephone_number": "715-892-6761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 GERTRUDE ST",
"city": "KAUKAUNA",
"state": "WI",
"postal_code": "541301128",
"telephone_number": "715-892-6761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHOMMER",
"first_name": "MATTHEW",
"middle_name": "JEFFREY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-09",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "221945-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kaukauna, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.