Wisconsin Cares PCW Network

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

WISCONSIN CARES PCW NETWORK

Practice address

500 W Silver Spring Dr Ste K200
Glendale, WI 53217-5052

Phone

(414) 374-3700

NPI assigned

Jan 23, 2025

Organization subpart

No

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

Authorized official

Name

Shayla D JeffersonNPI 1669926564

Title

Administrator

Phone

(414) 374-3700

Specialties & licenses 1

Addresses

Other names 1

• Wisconsin Cares Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shayla Jefferson, PMHNP, APNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Milwaukee, WI
  • NPI 1669926564
  NPD Authorized official

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1841002136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W SILVER SPRING DR STE K200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SILVER SPRING DR STE K200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175052",
            "telephone_number": "414-374-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN CARES PCW NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "SHAYLA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "414-374-3700"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wisconsin Cares",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wisconsin Cares",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brit Marie Williams-Van Klooster, MSW, CAPSW
• Kenyada M Williams
• Stephanie Lynn Wilman
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• Wisconsin Dental Group, S.C.

• All providers in Glendale, WI
• In Home Supportive Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.