Active NPI
Jolleen Mary Nichols, DNP
- Nurse Practitioner
- Clear Lake, WI
National Provider Identifier
1770134892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 9572
- Practice address
- 357 Third Ave
Clear Lake, WI 54005 - Phone
- (715) 268-8000
- NPI assigned
- Sep 20, 2019
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 9572 | WI | |
| Nurse Practitioner | 363L00000X | 9572 | WI | Primary |
Addresses
Primary practice location
357 Third Ave
Clear Lake, WI 54005
Mailing address
8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425
Other practice location 1
265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Amery |
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, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
265 Griffin E St
Amery, WI 54001-1439
Phone (715) 268-8000
265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000
Hospital & facility affiliations
- Adoray Home Health and Hospice
- Good Samaritan Society - Home Care
- Amery Hospital & Clinic
- Lakeview Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9572 | WI | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Past | Accepting new patients |
Locations
265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301
Organizations & group practices 4
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.
-
- Critical Access Hospital
- Amery, WI
- NPI 1093763518
-
- Rural Health Clinic/Center
- Clear Lake, WI
- NPI 1366878449
-
- Rural Health Clinic/Center
- Luck, WI
- NPI 1851345268
-
- Rural Health Clinic/Center
- Turtle Lake, WI
- NPI 1538384466
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Amery, WI
- NPI 1093763518
-
- Rural Health Clinic/Center
- Clear Lake, WI
- NPI 1366878449
Hospital
-
- Rural Health Clinic/Center
- Turtle Lake, WI
- NPI 1538384466
Hospital
-
- Home Health Agency
- Baldwin, WI
- NPI 1689679094
-
- Home Health Agency
- Saint Croix Falls, WI
- NPI 1568627156
-
- General Acute Care Hospital
- Stillwater, MN
- NPI 1538138003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762992000000",
"number": "1770134892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"address_2": "MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "55425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "357 THIRD AVE",
"city": "CLEAR LAKE",
"state": "WI",
"postal_code": "54005",
"telephone_number": "715-268-8000"
}
],
"practiceLocations": [
{
"address_1": "265 Griffin St E",
"address_purpose": "LOCATION",
"city": "Amery",
"state": "WI",
"postal_code": "540011439",
"country_code": "US",
"telephone_number": "715-268-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICHOLS",
"first_name": "JOLLEEN",
"middle_name": "MARY",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-20",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "9572",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "9572",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Amery",
"affiliation": "N",
"address_1": "265 Griffin St E",
"city": "Amery",
"state": "WI",
"country_code": "US",
"postal_code": "540011439",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clear Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.