Jennifer Thomas, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35632 Issued in WI

Practice address

4202 W. Oakwood Park CT.
Ste 200
Franklin, WI 53132-9565

Phone

(414) 423-5250

Fax

(414) 423-5256

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Rucka Former name

Electronic endpoints 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jthomas47309@direct.myadvocateaurora.org

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.

• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • Saint Francis, WI
  • NPI 1003861188
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1578573382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 15TH AVE",
            "address_2": "#180",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721160",
            "telephone_number": "414-768-5430",
            "fax_number": "414-762-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 W. OAKWOOD PARK CT.",
            "address_2": "STE 200",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329565",
            "telephone_number": "414-423-5250",
            "fax_number": "414-423-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "35632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32207000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jthomas47309@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4202 W. Oakwood Park Ct.",
            "address_2": "Ste 200",
            "city": "Franklin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531329565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4202 W. Oakwood Park Ct.",
            "address_2": "Ste 200",
            "city": "Franklin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531329565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RUCKA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lynne A Tetzlaff, R.PH.
• Chandni C Thakkar
• The Sleep Wellness Institute Inc
• Nicholas James Thein, RN
• Ren Theyerl
• Ridley Thomas
• Keara Thompson, PT, DPT
• Three Rivers Medical Transportation
• Joshua Thurm, DC
• Katherine Thurmond

• Pediatrics Physician in Franklin, WI
• Providers in Franklin, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.