Active NPI
Jan Mailloux, PA-C
- Physician Assistant
- Mineral Point, WI
National Provider Identifier
1790330256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 932-23
- Practice address
- 856 Fair St
Mineral Point, WI 53565-1409 - Phone
- (608) 987-5987
- NPI assigned
- Aug 1, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 932-23 | WI | Primary |
Addresses
Primary practice location
856 Fair St
Mineral Point, WI 53565-1409
Mailing address
2649 County Road a
Mineral Point, WI 53565-9123
Phone (608) 987-1166
Other names 1
- Jan Schaaf (Maiden)
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 932-23 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1790330256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2649 COUNTY ROAD A",
"city": "MINERAL POINT",
"state": "WI",
"postal_code": "535659123",
"telephone_number": "608-987-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "856 FAIR ST",
"city": "MINERAL POINT",
"state": "WI",
"postal_code": "535651409",
"telephone_number": "608-987-5987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAILLOUX",
"first_name": "JAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-01",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "932-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JAN",
"last_name": "SCHAAF (MAIDEN)",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mineral Point, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.