Active NPI
Jessica Beth Michaud, PHARM.D., BCPS
- Pharmacotherapy Pharmacist
- Milwaukee, WI
National Provider Identifier
1649338682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 16578-40
- Practice address
- 9200 W Wisconsin Ave
Milwaukee, WI 53226-3522 - Phone
- (414) 805-6575
- NPI assigned
- Dec 4, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 051.289448 | IL | |
| Pharmacotherapy Pharmacist | 1835P1200X | 16578-40 | WI | Primary |
Addresses
Primary practice location
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Mailing address
1857 N 73Rd St
Wauwatosa, WI 53213-2254
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051.289448 | Other | IL | IL STATE LICENSE |
| 16578-40 | Other | WI | WI LICENSE |
| 03-1-24675 | Other | OH | OH STATE LICENSE |
Other names 1
- Dr. Jessica Beth Mitchell
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.289448 | IL | MD | Pharmacotherapy Pharmacist |
| 16578-40 | WI | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353456000000",
"number": "1649338682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1857 N 73RD ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-6575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAUD",
"first_name": "JESSICA",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "PHARM.D., BCPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2012-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "IL",
"license": "051.289448",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "WI",
"license": "16578-40",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL STATE LICENSE",
"identifier": "051.289448",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI LICENSE",
"identifier": "16578-40",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH STATE LICENSE",
"identifier": "03-1-24675",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "MITCHELL",
"middle_name": "BETH",
"prefix": "DR.",
"credential": "PHARM.D., BCPS",
"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 Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.