Jennifer L Reichardt, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3157 Issued in WI

Practice address

W5282 Amy Ave
Appleton, WI 54915-7233

Phone

(920) 358-1900

NPI assigned

Aug 7, 2007

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer L Mattioli Former name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmattioli11383@direct.thedacare.org

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.

• Thedacare, Incorporated

  dba ThedaCare Physicians

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  NPD (past)

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811188683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5282 AMY AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157233",
            "telephone_number": "920-358-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 E Enterprise Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549137729",
            "country_code": "US",
            "telephone_number": "920-954-2551",
            "fax_number": "920-954-2554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 Deerwood Ave",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549567110",
            "country_code": "US",
            "telephone_number": "920-727-9982",
            "fax_number": "920-727-9983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REICHARDT",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "3157",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "3157",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MATTIOLI",
            "middle_name": "L",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mark William Reich, MS PSYCHOLOGY
• Chrystal Jean Reichard, DPT, GCS
• James Edward Reider, SAC-IT
• Haley Reierson, PT
• Jennifer Rae Reihl, COTA
• Samuel Jordan Rein, DPT
• William Jack Rein, MPT

• Family Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.