Jacqueline Landess, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

7146520 Issued in WI

Practice address

1118 Professional Dr
Dodgeville, WI 53533-1176

Phone

(608) 935-2838

Fax

(608) 935-9227

NPI assigned

Jun 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23045/brand/1/csg/1/fhir/r4

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.

• Monarch Health

  • Addiction Medicine (Internal Medicine) Physician
  • Madison, WI
  • NPI 1922627595
  NPD

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1497066351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 PROFESSIONAL DR",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331176",
            "telephone_number": "608-935-2838",
            "fax_number": "608-935-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 PROFESSIONAL DR",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331176",
            "telephone_number": "608-935-2838",
            "fax_number": "608-935-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDESS",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0053994",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "7146520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara A Kolb, LCSW
• Diana M Kroeber, CACD III
• Haley Elizabeth Krueger
• Lori Kuntz, LCSW
• Angela Kussow, RDH
• Wilmari Laureano-Melendez, PHARMD
• Sadie Lawson, MSW
• Brenda M Lee, RDH
• John Mark Lehman, DO
• Kristin Meredith Lindner

• Psychiatry Physician in Dodgeville, WI
• Providers in Dodgeville, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.