Katherine Jackson-Schneider, D.O.

Individual provider Active NPI Family Medicine Physician · Stanley, WI

NPI 1871614545 · NPPES record last updated Nov 3, 2021

Key facts

NPI
1871614545
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
75408-21 (WI)
Practice address
1120 Pine St
Stanley, WI 54768-1297
Phone
(715) 644-5530
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 7

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Stanley Hospital and Clinics Inc (34 clinicians)

Practice addresses (Care Compare)

1120 Pine St
Stanley, WI 54768-1297
Phone (715) 644-5530

Hospital & facility affiliations

  • Aspirus Stanley Hospital Hospital · Stanley, WI · CCN 521311
  • Aspirus Medford Hospital & Clinics, Inc Hospital · Medford, WI · CCN 521324
  • Clark County Rehabilitation & Living Center Nursing home · Owen, WI · CCN 525403

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210622000878 WI Practitioner - Family Practice 0749357283 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Stanley Hospital & Clinics, Inc. Family Medicine Current Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc Family Medicine Current Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

6 Johnson St
Owen, WI 54460
Phone (715) 229-2177

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

704 S Clark St
Thorp, WI 54771
Phone (715) 669-5536

Interoperability endpoints

  • Direct secure messaging: kjacksonschneider169371@direct.aspirus.org
  • Direct secure messaging: kjackson4894@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 75408-21 WI Yes

Addresses

Primary practice location

1120 Pine St
Stanley, WI 54768-1297

Mailing address

1120 Pine St
Stanley, WI 54768-1297
Phone (715) 644-5530

Other identifiers

IdentifierTypeStateIssuer
51001016612OtherMIPHYSICIAN LICENSE
1871614545OtherNPI
75408-21OtherWIWISCONSIN MEDICAL LICENSE

Other names

  • Katherine Jackson Former name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address katherine.jackson-schneider@aspirus.org Direct Our Lady of Victory Hospital

Other providers in Stanley, WI

All providers in Stanley, WI · Family Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.