Individual provider Active NPI

Jessica Mary Stoiber, AGACNP-BC

  • Primary Care Nurse Practitioner
  • Spring Valley, WI
National Provider Identifier
1487417879
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2023189444 Issued in WI
Practice address
W4401 State Road 29
Spring Valley, WI 54767-8311
Phone
(715) 317-1185
NPI assigned
Jan 30, 2024
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X
Primary Care Nurse Practitioner 363LP2300X 2023189444 WI Primary

Addresses

Primary practice location

W4401 State Road 29
Spring Valley, WI 54767-8311

Mailing address

W4401 State Road 29
Spring Valley, WI 54767-8311
Phone (715) 317-1185

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
I20240529001887 WI Practitioner - Nurse Practitioner 7012359540 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023189444WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince May 1, 2024 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

250 E Wisconsin Ave
Fl 18
Milwaukee, WI 53202
Phone (303) 748-5781

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJFADD/Endpoint/FJFADD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1487417879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W4401 STATE ROAD 29",
            "city": "SPRING VALLEY",
            "state": "WI",
            "postal_code": "547678311",
            "telephone_number": "715-317-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W4401 STATE ROAD 29",
            "city": "SPRING VALLEY",
            "state": "WI",
            "postal_code": "547678311",
            "telephone_number": "715-317-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOIBER",
        "first_name": "JESSICA",
        "middle_name": "MARY",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "2023189444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, WI

Sources for this page

Verify at the official NPI Registry.