Jessica Jannette Hendricks, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5442-33 Issued in WI

Practice address

618 Memorial Dr
Chilton, WI 53014-1568

Phone

(920) 849-3800

NPI assigned

Sep 2, 2013

Last updated

Dec 30, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WI

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 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group-Fox Valley Wisconsin, IncGroup PAC ID 0244142420, 260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Calumet County HHC Agency Home health agency, Chilton, WI, CCN 527085
• Ascension Calumet Hospital Hospital, Chilton, WI, CCN 521317

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  dba Ascension Medical Group

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment Care Compare group NPD
• Ascension Calumet Hospital, Inc

  dba Ascension Calumet Hospital

  • Critical Access Hospital
  • Chilton, WI
  • NPI 1376541748
  Medicare reassignment NPD
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD

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

• Ascension Calumet Hospital, Inc

  dba Ascension Calumet Hospital

  • Critical Access Hospital
  • Chilton, WI
  • NPI 1376541748
  Care Compare affiliation
• Calumet County

  • Home Health Agency
  • Chilton, WI
  • NPI 1396736831
  Care Compare affiliation

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

{
    "created_epoch": "1378080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1720412299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 MEMORIAL DR",
            "city": "CHILTON",
            "state": "WI",
            "postal_code": "530141568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 MEMORIAL DR",
            "city": "CHILTON",
            "state": "WI",
            "postal_code": "530141568",
            "telephone_number": "920-849-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "JESSICA",
        "middle_name": "JANNETTE",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-02",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "5442-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Lucia Gaulke, OTR/L
• Amy Gauthier, DPT
• Christine Marie Goetsch, PTA
• Amanda Hackbarth, APNP
• Hand to Shoulder Center of Wisconsin, LTD.
• Adrienne Houser
• Katherine Elizabeth Hylok, PT
• Ihc-Calumet Emergency Physicians, LLC
• Peter G Janu, MD
• Clarissa Justmann

• Adult Health Nurse Practitioner in Chilton, WI
• Providers in Chilton, WI by specialty
• Adult Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.