Individual provider Active NPI

Jennifer Jeannine Vidonish, CNP

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1689924888
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15948-33 Issued in WI
Practice address
1650 N Farwell Ave
Milwaukee, WI 53202-2331
Phone
(866) 389-2727
NPI assigned
Sep 14, 2012
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X GAA-NP003408 GA
Family Medicine Physician 207Q00000X APRN.CNP.137441 OH
Family Nurse Practitioner 363LF0000X 15948-33 WI Primary
Family Medicine Physician 207Q00000X 12.015771 CT
Family Medicine Physician 207Q00000X 5022075 NC
Family Medicine Physician 207Q00000X 0024192748 VA
Family Medicine Physician 207Q00000X 35825 NY
Family Medicine Physician 207Q00000X CNP241569 ME
Family Medicine Physician 207Q00000X APRN11035524 FL

Addresses

Primary practice location

1650 N Farwell Ave
Milwaukee, WI 53202-2331

Mailing address

431 Saint Johns Rd
Delafield, WI 53018-1438
Phone (419) 565-0309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, ME, VA, DC, NC, GA6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20241120002945 WI Practitioner - Nurse Practitioner 6103053434 Reassigns benefits to 2 organizations
I20250311002779 ME Practitioner - Nurse Practitioner 6103053434 Reassigns benefits to 1 organization
I20250508002051 VA Practitioner - Nurse Practitioner 6103053434 Reassigns benefits to 1 organization
I20250512000242 DC Practitioner - Nurse Practitioner 6103053434 Reassigns benefits to 1 organization
I20250604001749 NC Practitioner - Nurse Practitioner 6103053434 Reassigns benefits to 1 organization
I20251110000771 GA Practitioner - Nurse Practitioner 6103053434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minuteclinic Diagnostic of Virginia LLCGroup PAC ID 6709960891, 142 clinicians
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

19305 Ruby Dr
Leesburg, VA 20176-6508
Phone (866) 389-2727

2340 Spring Forest Rd
Raleigh, NC 27615-7528
Phone (866) 389-2727

2738 N Decatur Rd
Decatur, GA 30033-5910
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12.015771CTMDFamily Medicine Physician
APRN11035524FLMDFamily Medicine Physician
GAA-NP003408GAMDFamily Medicine Physician
CNP241569MEMDFamily Medicine Physician
5022075NCMDFamily Medicine Physician
35825NYMDFamily Medicine Physician
APRN.CNP.137441OHMDFamily Medicine Physician
15948-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Virginia LLC Family CurrentSince Apr 30, 2025 Accepting new patients
Minuteclinic Diagnostic of Wisconsin, LLC Family CurrentSince Oct 25, 2024 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince May 29, 2025 Accepting new patients
Minuteclinic Diagnostic of Maine, LLC Family CurrentSince Jan 5, 2025 Accepting new patients
Minuteclinic Video Virtual Care of Wisconsin, SC Family Medicine CurrentSince Oct 25, 2024 Accepting new patients

Locations

51 Market St
South Portland, ME 04106
Phone (207) 799-2261

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

1 Cvs Dr
#2295
Woonsocket, RI 02895
Phone (401) 770-8043

1636 Belle View Blvd
Alexandria, VA 22307
Phone (703) 703-7687

19305 Ruby Dr
Leesburg, VA 20176
Phone (571) 333-5918

1650 N Farwell Ave
Milwaukee, WI 53202
Phone (414) 277-5044

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1689924888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 SAINT JOHNS RD",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181438",
            "telephone_number": "419-565-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 N FARWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022331",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDONISH",
        "first_name": "JENNIFER",
        "middle_name": "JEANNINE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "GAA-NP003408",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "APRN.CNP.137441",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "15948-33",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "12.015771",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "5022075",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0024192748",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "35825",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "CNP241569",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11035524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.