Active NPI
Timothy W Jahn, M.D.
- Emergency Medicine Physician
- Milwaukee, WI
National Provider Identifier
1508896747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 39528-020
- Practice address
- 111 E Wisconsin Ave
Suite 2000
Milwaukee, WI 53202-4815 - Phone
- (414) 290-6720
- Fax
- (414) 290-6755
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 39528-020 | WI | Primary |
| Emergency Medicine Physician | 207P00000X | 036-094421 | IL |
Addresses
Primary practice location
111 E Wisconsin Ave
Suite 2000
Milwaukee, WI 53202-4815
Mailing address
111 E Wisconsin Ave
Suite 2000
Milwaukee, WI 53202-4815
Phone (414) 290-6720
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32407500 | Medicaid | WI | |
| 930077440 | Other | WI | MEDICARE RAILROAD |
| 930080582 | Other | WI | MEDICARE RAILROAD |
| P00030958 | Other | WI | MEDICARE RAILROAD |
| 104160648 | Medicaid | MI | |
| 930106600 | Other | WI | MEDICARE RAILROAD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-094421 | IL | MD | Emergency Medicine Physician |
| 39528-020 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc-Sacred Heart Emergency Physicians, LLC | Emergency Medicine | Past | Accepting new patients |
| Ihc-St. Francis Emergency Physicians, LLC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Eau Claire, WI
- NPI 1992847826
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1780632463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224201600000",
"number": "1508896747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E WISCONSIN AVE",
"address_2": "SUITE 2000",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532024815",
"telephone_number": "414-290-6720",
"fax_number": "414-290-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E WISCONSIN AVE",
"address_2": "SUITE 2000",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532024815",
"telephone_number": "414-290-6720",
"fax_number": "414-290-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAHN",
"first_name": "TIMOTHY",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2008-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "39528-020",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036-094421",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32407500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "930077440",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "930080582",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00030958",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104160648",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "930106600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.