Individual provider Active NPI

Jason M Jeske, R.N.

  • Registered Nurse
  • Oshkosh, WI
National Provider Identifier
1629563267
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
218207-30 Issued in WI
Practice address
1091 Park Ridge Ave
Oshkosh, WI 54901-1593
Phone
(920) 527-9755
NPI assigned
Jun 26, 2018
Last updated
Jun 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 218207-30 WI Primary

Addresses

Primary practice location

1091 Park Ridge Ave
Oshkosh, WI 54901-1593

Mailing address

1091 Park Ridge Ave
Oshkosh, WI 54901-1593
Phone (920) 527-9755

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
218207-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1629563267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 PARK RIDGE AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011593",
            "telephone_number": "920-527-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 PARK RIDGE AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011593",
            "telephone_number": "920-527-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESKE",
        "first_name": "JASON",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "218207-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.