NPIMap

Jacob Ryan Webber, FNP

Individual provider Active NPI Nurse Practitioner · Sheboygan, WI

NPI 1760196893 · NPPES record last updated Oct 17, 2024

Key facts

NPI
1760196893
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
13592-33 (WI)
Practice address
3100 Superior Ave
Sheboygan, WI 53081-1948
Phone
(920) 496-4700
NPI assigned
Jan 12, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 19

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.

Hospital & facility affiliations 9

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Nicholas Hospital-Sisters of the Third Order of St Francis (178 clinicians)
Apogee Medical Group Wisconsin SC (42 clinicians)
St Clare Memorial Hospital, Inc (62 clinicians)

Practice addresses (Care Compare)

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (920) 459-8300

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3500

835 S Main St
Oconto Falls, WI 54154-1282

855 S Main St
Oconto Falls, WI 54154-1241
Phone (920) 846-8187

PO Box
Suite 19070
Green Bay, WI 54307-9070

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital · Green Bay, WI · CCN 520049
  • St Nicholas Hospital Hospital · Sheboygan, WI · CCN 520044
  • Watertown Memorial Hospital Hospital · Watertown, WI · CCN 520116
  • HSHS St Clare Memorial Hospital Hospital · Oconto Falls, WI · CCN 521310
  • Bellin Health Oconto Hospital Hospital · Oconto, WI · CCN 521356

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI, MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230427002730 WI Practitioner - Nurse Practitioner 1759746647 Reassigns benefits to 4 organizations
I20240711000969 MI Practitioner - Nurse Practitioner 1759746647 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13592-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current
since Jun 1, 2024		 Accepting new patients
Apogee Medical Group, Wisconsin, S.C Current
since Mar 1, 2023		 Accepting new patients
St Clare Memorial Hospital, Inc Current
since Jun 1, 2024		 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current
since Jun 1, 2024		 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current
since Jun 1, 2024		 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Nurse Practitioner Current
since Apr 13, 2024		 Accepting new patients
St. Clare Memorial Hospital, Inc Current
since Jun 1, 2024		 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Current
since Apr 13, 2024		 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis Current
since Jun 1, 2024		 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

1621 N Taylor Dr
Ste 200
Sheboygan, WI 53081
Phone (920) 458-5864

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

Interoperability endpoints

  • Direct secure messaging: jwebber431419@ewd.direct.hshs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 13592-33 WI Yes

Addresses

Primary practice location

3100 Superior Ave
Sheboygan, WI 53081-1948

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other identifiers

IdentifierTypeStateIssuer
100231423MedicaidWI

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address jwebber431419@ewd.direct.hshs.org Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 17, 2024.

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1760196893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SUPERIOR AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811948",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBBER",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-12",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13592-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100231423",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwebber431419@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "3100 Superior Ave",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530811948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sheboygan, WI

All providers in Sheboygan, WI · Nurse Practitioner in Wisconsin

Sources for this page

Verify at the official NPI Registry.