Active NPI
Jenna Nelson
- Physical Therapist
- Beaver Dam, WI
National Provider Identifier
1710814736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17743
- Practice address
- 707 S University Ave
Beaver Dam, WI 53916-3027 - Phone
- (920) 887-7181
- NPI assigned
- May 5, 2026
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 17743 | WI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
707 S University Ave
Beaver Dam, WI 53916-3027
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1000 N Oak Ave
Marshfield, WI 54449-5702
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 8
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.
-
- Clinic/Center
- Beaver Dam, WI
- NPI 1972188555
-
- Clinic/Center
- Park Falls, WI
- NPI 1194317966
-
- Critical Access Hospital
- Park Falls, WI
- NPI 1700963048
-
- Clinic/Center
- Rice Lake, WI
- NPI 1093201832
-
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
-
- Clinic/Center
- Marshfield, WI
- NPI 1093221434
-
- Critical Access Hospital
- Ladysmith, WI
- NPI 1952890873
-
- Critical Access Hospital
- Neillsville, WI
- NPI 1346239373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781136000000",
"number": "1710814736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495703",
"telephone_number": "715-387-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 S UNIVERSITY AVE",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163027",
"telephone_number": "920-887-7181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-05",
"last_updated": "2026-06-11",
"certification_date": "2026-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "17743",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
"affiliation": "N",
"address_1": "707 S University Ave",
"city": "Beaver Dam",
"state": "WI",
"country_code": "US",
"postal_code": "539163027",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Beaver Dam, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.