Jessica L Jach, LCSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9310-123 Issued in WI

Practice address

2600 Humes Rd Ste 100
Janesville, WI 53545-0491

Phone

(608) 741-2117

Fax

(608) 758-5761

NPI assigned

Sep 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jessica L Peterson 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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD (past)

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1699143909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 HUMES RD STE 100",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450491",
            "telephone_number": "608-741-2117",
            "fax_number": "608-758-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 HUMES RD STE 100",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450491",
            "telephone_number": "608-741-2117",
            "fax_number": "608-758-5761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 E Court St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535453919",
            "country_code": "US",
            "telephone_number": "608-755-8923",
            "fax_number": "608-758-5761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACH",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "LCSW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "129191-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9310-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699143909",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PETERSON",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David R. Isaacson, MD
• Chase Michael Isenberger, PA
• Brittany Elizabeth Itnyre, COTA
• Rajeshwari N Iyer, MPT
• J&T Transit
• Bradley Jackson
• Shirley Jean Jackson, RN
• Brenda Lee Jacobs, RPH
• Julie A Jacobs, PH.D.
• Stephen Christiaan Jacobs, MD

• Clinical Social Worker in Janesville, WI
• Providers in Janesville, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.