Jennifer Diane Johnson · Jennifer Diane Psota · Family Nurse Practitioner

725 American Avenue, Waukesha, WI 53188

Overview

Jennifer Diane Johnson is a Family Nurse Practitioner practicing in Waukesha, Wisconsin. The National Provider Identifier (NPI) is #1043615560, which was assigned on October 27, 2014, and the registration record was last updated on December 12, 2024. The practitioner's main practice location is at 725 American Avenue, Waukesha, WI 53188; the contact telephone number is 2129288800, and the fax number is 2629280648. The primary taxonomy of Jennifer Diane Johnson is Family Nurse Practitioner (363LF0000X), with specialization in Family. Jennifer Diane Johnson is licensed to practice in the state of Wisconsin (#6088-33), Wisconsin (#171464-30), Wisconsin (#6088-33).

Provider Information

NPI 1043615560
Entity Type Individual
Provider Name JENNIFER DIANE JOHNSON
Other Name JENNIFER DIANE PSOTA
(Former Name)
Gender Female
Credential FNP
Other Credential FNP
Practice Address 725 American Avenue
Waukesha
WI 53188
Practice Telephone 2129288800
Practice Fax Number 2629280648
Mailing Address 27431 N. Lake Drive
Waterford
WI 53185
Mailing Telephone 6083588449
Certification Date 2024-12-12
Enumeration Date 2014-10-27
Last Update Date 2024-12-12
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 1658695077
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name JENNIFER JOHNSON
Primary Specialty NURSE PRACTITIONER
Organization Legal Name PROHEALTH MEDICAL GROUP INC
Address 725 American Ave
Waukesha
WI 53188-5031

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N363L00000XNurse Practitioner6088-33WI
N163W00000XRegistered Nurse171464-30WI
Y363LF0000XNurse PractitionerFamily6088-33WI

Other Provider Identifiers

Other IdentifierIssuing StateIssuerIdentifier Type
100041913WIMEDICAID

Secondary Practice Locations

AddressTelephoneFax
725 American Ave, Waukesha, WI 5318850312629288800

Taxonomy Information

Primary Taxonomy

Code 363LF0000X
Taxonomy Family Nurse Practitioner
Classification Nurse Practitioner
Specialization Family
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: Definition to come...

Other Taxonomy

Code 363L00000X
Taxonomy Nurse Practitioner
Classification Nurse Practitioner
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses' Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Other Taxonomy

Code 163W00000X
Taxonomy Registered Nurse
Classification Registered Nurse
Grouping Nursing Service Providers
Definition: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

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Location Information

Street Address 725 AMERICAN AVENUE
City WAUKESHA
State WI
Zip Code 53188
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Mary Conti Swiontoniowski 725 American Avenue, Room 2036, Waukesha, WI 53188Hospitalist Physician2006-02-13
Patrick Robert Gangnon 725 American Avenue, Waukesha, WI 53188Speech-Language Pathologist2007-09-05

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Zoe Penczykowski 514 Riverview Avenue, Waukesha, WI 53188Case Manager/Care Coordinator2022-07-26
Lynne Sarah Alva 711 Moreland Blvd, Suite 204, Waukesha, WI 53188Dental Hygienist2016-09-01
Ashley Susan Callahan 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188Dental Hygienist2018-07-19
Therapeutic Healing, LLC 2609 N. Grandview Blvd., Suite 150, Waukesha, WI 53188Occupational Therapist2014-02-13
Loyal Loving Hands Healthcare LLC N91w24400 Riverwood Drive, Suite 350, Waukesha, WI 53188Personal Care Attendant2025-05-02
Rhonda Schroeder W286 N991 Shepherds Way, Waukesha, WI 53188Dental Hygienist2014-04-29
Melissa Ann Kohnert N17w24222 Riverwood, 170, Pewaukee, WI 53188Clinical Social Worker2024-12-09
Emily Elizabeth Seefeld 29667 Summit Ave S11, Waukesha, WI 53188Occupational Therapy Assistant2018-12-05
Patricia Marie Sombrio · Sombrio Marie Vanderheyden 711 Moreland Blvd 204, Waukesha, WI 53188Dental Hygienist2017-09-04
Breathe Wellness & Prenatal Care LLC 2607 N. Gradview Blvd, Suite 110, Waukesha, WI 53188Mental Health Clinic/Center (Including Community Mental Health Center)2024-01-26
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.