Jessica Lynn Brumm-Larson, PHD, LPC, NCSP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3263-57 Issued in WI

Practice address

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874

Phone

(414) 266-2932

Fax

(414) 266-3735

NPI assigned

Aug 4, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jessica Lynn Brumm Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbrummlarson92003@direct.chw.org

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• Children'S Hospital of Wisconsin, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Milwaukee, WI
  • NPI 1952408353
  NPD (past)
• Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1942970405
  NPD (past)

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1699089490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2932",
            "fax_number": "414-266-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2932",
            "fax_number": "414-266-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMM-LARSON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3263-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660631",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699089490",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BRUMM",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Brukman
• Raymond Scott Brumblay, M.D.
• Amber J. Brumfield, RN
• Keanna Brumfield
• Tytiana Monquie Brumley
• Jennifer Brumm-Maciejewski
• Charles F Brummitt, M.D.
• Jessica Ann Brundage, PH.D.
• Thomas Stephen Brundage
• Cynthia R Brune, MS ART THERAPY

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.