Jay Mitchell Jevne, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9972 Issued in WI

Practice address

1110 7TH Ave
Cumberland, WI 54829-9138

Phone

(715) 822-7500

NPI assigned

Jan 2, 2020

Last updated

Mar 12, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Lakes Community Health Center IncGroup PAC ID 0840366654, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center - Rice Lake Hospital, Rice Lake, WI, CCN 520011

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jay.jevne@cumberland-directmessage.com
• Direct secure messaging: jjevne611859@direct.ochin.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.

• The Lakes Community Health Center, Inc

  dba NorthLakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Iron River, WI
  • NPI 1811178825
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  WI

  Medicare reassignment
• The Lakes Community Health Center, Inc

  dba NorthLakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • White Lake, WI
  • NPI 1679983423
  NPD

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

• Lakeview Medical Center Inc of Rice Lake

  dba Marshfield Medical Center - Rice Lake

  • Rural Acute Care Hospital
  • Rice Lake, WI
  • NPI 1154415024
  Care Compare affiliation

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1942849484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 6TH AVE",
            "city": "CUMBERLAND",
            "state": "WI",
            "postal_code": "548299103",
            "telephone_number": "715-822-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 7TH AVE",
            "city": "CUMBERLAND",
            "state": "WI",
            "postal_code": "548299138",
            "telephone_number": "715-822-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEVNE",
        "first_name": "JAY",
        "middle_name": "MITCHELL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-02",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9972",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "9972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee R Jacobson, OD
• JB Signature Homes, LLC
• Craig Alexander Jennings, MD
• Kaitlyn Jensen, LAT, PTA
• Karen Elizabeth Jergenson, RN
• Abigail Chrisine Johnson
• Kelly Jo Johnson, RDN, CD
• Bruce Jungerberg, PHD
• Cassandra Laurine Klatt
• Darlene Kay Kleinschmidt, COTA

• Psychiatric/Mental Health Nurse Practitioner in Cumberland, WI
• Providers in Cumberland, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.