Individual provider Active NPI

Jacqueline M Thomson-Ehlers, RN, BSN, MS

  • Ambulatory Care Registered Nurse
  • Appleton, WI
National Provider Identifier
1740423300
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
92132-30 Issued in WI
Practice address
10 Tri Park Way
Appleton, WI 54914-1658
Phone
(920) 831-0070
Fax
(920) 831-7939
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 92132-30 WI Primary

Addresses

Primary practice location

10 Tri Park Way
Appleton, WI 54914-1658

Mailing address

10 Tri Park Way
Appleton, WI 54914-1658
Phone (920) 831-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
92132-30WIMDAmbulatory Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Vamc PastSince Aug 1, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1740423300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-0070",
            "fax_number": "920-831-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-0070",
            "fax_number": "920-831-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON-EHLERS",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "WI",
            "license": "92132-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.