Active NPI
Jennifer Jury McIntosh, D.O.
- Maternal & Fetal Medicine Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- 63633
- Practice address
- 9200 W Wisconsin Ave
Dept of Obstetrics and Gynecology
Milwaukee, WI 53226-3522 - Phone
- (414) 805-6624
- Fax
- (414) 805-6622
- NPI assigned
- Feb 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 63633 | WI | |
| Maternal & Fetal Medicine Physician | 207VM0101X | 5018 | OK | |
| Maternal & Fetal Medicine Physician | 207VM0101X | 63633 | WI | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 11013849A | IN |
Addresses
Primary practice location
9200 W Wisconsin Ave
Dept of Obstetrics and Gynecology
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Dept of Obstetrics and Gynecology
Milwaukee, WI 53226-3522
Phone (414) 805-6624
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578732897 | Medicaid | WI |
Other names 1
- Dr. Jennifer Lyn Jury
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmcintosh347589@direct-ehr-ssmhc.com | Direct | AGNESIAN HEALTHCARE INC |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | AGNESIAN HEALTHCARE INC |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Michigan State University College of Osteopathic Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
17280 W N Ave
Suite 200
Brookfield, WI 53045-4366
Phone (262) 754-8000
8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666
8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666
Hospital & facility affiliations
- Froedtert Memorial Lutheran Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5018 | OK | MD | Professional Counselor |
| 11013849A | IN | MD | Obstetrics & Gynecology Physician |
| 63633 | WI | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin Inc | Past | Accepting new patients |
Locations
1905 N Calhoun Rd
Brookfield, WI 53005
Phone (262) 333-0040
17280 W North Ave
Ste 200
Brookfield, WI 53045
Phone (262) 240-9640
430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200
420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540
3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533
Interoperability endpoints
- jmcintoshmd175065@direct.froedtert.com
- jmcintosh347589@direct-ehr-ssmhc.com
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
-
- Case Management Agency
- Milwaukee, WI
- NPI 1649521105
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1255334173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608508800000",
"number": "1578732897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"address_2": "DEPT OF OBSTETRICS AND GYNECOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-6624",
"fax_number": "414-805-6622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"address_2": "DEPT OF OBSTETRICS AND GYNECOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-6624",
"fax_number": "414-805-6622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTOSH",
"first_name": "JENNIFER",
"middle_name": "JURY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-21",
"last_updated": "2020-12-21",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WI",
"license": "63633",
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "OK",
"license": "5018",
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "WI",
"license": "63633",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IN",
"license": "11013849A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1578732897",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmcintosh347589@direct-ehr-ssmhc.com",
"affiliation": "Y",
"affiliationName": "AGNESIAN HEALTHCARE INC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "jmcintosh347589@direct-ehr-ssmhc.com",
"address_1": "420 E Division St",
"city": "Fond Du Lac",
"state": "WI",
"country_code": "US",
"postal_code": "549354560",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "AGNESIAN HEALTHCARE INC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "420 E Division St",
"city": "Fond Du Lac",
"state": "WI",
"country_code": "US",
"postal_code": "549354560",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "JURY",
"middle_name": "LYN",
"prefix": "DR.",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}
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 Dec 21, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.