Active NPI
Shannon K Jacobi, NP
- Nurse Practitioner
- Franklin, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4466-33
- Practice address
- 3111 W Rawson Ave
Suite 200
Franklin, WI 53132-9417 - Phone
- (414) 384-6700
- Fax
- (414) 761-1921
- NPI assigned
- Aug 1, 2011
- Last updated
- Mar 3, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4466-33 | WI | Primary |
Addresses
Primary practice location
3111 W Rawson Ave
Suite 200
Franklin, WI 53132-9417
Mailing address
3077 N Mayfair Rd Ste 305
Wauwatosa, WI 53222-4305
Phone (414) 384-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760760391 | Medicaid | WI |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13950 W Capitol Dr
Brookfield, WI 53005-2441
Phone (414) 302-5400
3111 W Rawson Ave
Suite 200
Franklin, WI 53132-8890
Phone (414) 384-6700
3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011
3807 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8300
3809 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-5000
3811 Spring St
Mount Pleasant, WI 53405-1667
3821 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8460
7095 S Ballpark Dr
Suite 100
Franklin, WI 53132-6908
Phone (414) 817-6620
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.61 of 100
- Quality
- 73.65
- Promoting interoperability
- 87
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Orthopedic Specialty Hospital, LLC | Current | Accepting new patients | |
| Orthopedic Surgeons of Wisconsin, S.C. | Nurse Practitioner | Current | Accepting new patients |
| Ascension Medical Group-Southeast Wisconsin Inc | Nurse Practitioner | Current | Accepting new patients |
| Midwest Orthopedic Specialty Hospital, LLC | Current | Accepting new patients | |
| Midwest Orthopedic Specialty Hospital, LLC | Current | Accepting new patients |
Locations
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
17000 W Bluemound Rd
Ste L
Brookfield, WI 53005
Phone (262) 207-4680
3111 W Rawson Ave
Ste 200
Franklin, WI 53132
Phone (414) 325-4320
3111 W Rawson Ave
Ste 215
Franklin, WI 53132
Phone (414) 761-0727
7095 S Ballpark Dr
Unit 100
Franklin, WI 53132
Phone (414) 817-6620
9969 S 27th St
#1100
Franklin, WI 53132
9969 S 27th St
Ste 1100
Franklin, WI 53132
2901 W Kinnickinnic River Pkwy
Ste 102
Milwaukee, WI 53215
Phone (414) 385-7150
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
2323 N Mayfair Rd
Ste 300
Wauwatosa, WI 53226
Phone (414) 443-9862
3077 N Mayfair Rd
Ste 305
Wauwatosa, WI 53222
Phone (414) 258-3500
Interoperability endpoints
- shannon.jacobi.1@32957.direct.athenahealth.com
Organizations & group practices 5
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.
-
dba Ascension Medical Group
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
Nurse Practitioner
-
- Orthopaedic Surgery Physician
- Franklin, WI
- NPI 1275127375
-
- Orthopaedic Surgery Physician
- Wauwatosa, WI
- NPI 1295769321
Nurse Practitioner
-
- Orthopaedic Surgery Physician
- Brookfield, WI
- NPI 1750020897
-
- Durable Medical Equipment & Medical Supplies
- Muskego, WI
- NPI 1962238113
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension All Saints Hospital
- General Acute Care Hospital
- Racine, WI
- NPI 1639123284
-
dba Ascension St Francis Hospital
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1225087190
-
- Special Hospital
- Franklin, WI
- NPI 1861635971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1760760391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3077 N MAYFAIR RD STE 305",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532224305",
"telephone_number": "414-384-6700",
"fax_number": "414-727-1058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 W RAWSON AVE",
"address_2": "SUITE 200",
"city": "FRANKLIN",
"state": "WI",
"postal_code": "531329417",
"telephone_number": "414-384-6700",
"fax_number": "414-761-1921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBI",
"first_name": "SHANNON",
"middle_name": "K",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-01",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "4466-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1760760391",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Franklin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.