NPIMap

Jamie L Lodes, APNP

Individual provider Active NPI Nurse Practitioner · Appleton, WI

NPI 1649522368 · NPPES record last updated Oct 4, 2012

Key facts

NPI
1649522368
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
5080 (WI)
Practice address
1818 N Meade St
Appleton, WI 54911-3454
Phone
(920) 735-7645
Fax
(920) 735-7618
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 13

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, Incorporated (654 clinicians)

Practice addresses (Care Compare)

2500 E Capital Dr
Appleton, WI 54911-8735
Phone (920) 364-3600

Hospital & facility affiliations

  • Bristol Hospice Green Bay Hospice · Green Bay, WI · CCN 521610
  • Thedacare Regional Med Ctr - Neenah Hospital · Neenah, WI · CCN 520045
  • Thedacare Regional Medical Center - Appleton Inc Hospital · Appleton, WI · CCN 520160

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20121113000649 WI Practitioner - Nurse Practitioner 9739330077 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated Current
since Oct 3, 2012		 Accepting new patients
Thedacare, Incorporated Current
since Oct 3, 2012		 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: jlodes11246@direct.thedacare.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5080 WI Yes

Addresses

Primary practice location

1818 N Meade St
Appleton, WI 54911-3454

Mailing address

PO Box 8003
Appleton, WI 54912-8003
Phone (920) 996-3200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 4, 2012.

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1649522368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3200",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-735-7645",
            "fax_number": "920-735-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODES",
        "first_name": "JAMIE",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

All providers in Appleton, WI · Nurse Practitioner in Wisconsin

Sources for this page

Verify at the official NPI Registry.