JACALYN A NELSON (NPI# 1063430833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063430833 |
| Entity Type | Individual |
| Full Name | JACALYN A NELSON |
| Credential | MD |
| Practice Address |
2844 Index Rd Fitchburg WI 53713-3117 |
| Practice Telephone | 6082297979 |
| Practice Fax Number | 6082298110 |
| Mailing Telephone | 6082297979 |
| Mailing Fax Number | 6082298110 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
49405-020 | WI | Allopathic & Osteopathic Physicians |
| Y | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
49405-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1063430833 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700043734 | Jacalyn Nelson | Pharmacist | 705 Northland Dr, Princeton, MN 55371-2168 | 2008-05-19 |
| Street Address |
2844 INDEX RD |
| City | FITCHBURG |
| State | WI |
| Zip Code | 53713-3117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073577607 | Leann M Derungs | Nurse Practitioner | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2006-04-12 |
| 1972052371 | Michelle Mortensen | Physician Assistant | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2016-09-26 |
| 1528516036 | Ssm Health Care of Wisconsin Inc | Clinic/Center | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2016-09-13 |
| 1851648042 | Elizabeth A Saar | Physician Assistant | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2012-08-07 |
| 1295044527 | Megan A Rocke | Physician Assistant | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2010-10-05 |
| 1790957371 | Scott E. Johnson | Internal Medicine | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2008-03-24 |
| 1609092584 | Ewa I Alexander | Internal Medicine | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2007-04-18 |
| 1144380577 | Don A Harden | Internal Medicine | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2006-12-08 |
| 1417987736 | Joseph A Crisalli | Pediatrics | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2006-07-03 |
| 1629024047 | Kathryn L Middleton | Internal Medicine | 2844 Index Rd, St. Mary's Sllep Center, Fitchburg, WI 53713-3117 | 2006-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508406760 | Diana Kay Woodruff | Registered Nurse | Madison West Comprehensive Treatment Center, 151 E. Badger Rd. Suite A, Madison, WI 53713 | 2020-01-15 |
| 1568008886 | Avery Reven Kansteiner | Counselor | 105 Ski Court, Madison, WI 53713 | 2019-11-21 |
| 1518501329 | Erica D Anderson | Counselor | 1125 W Badger Rd Apt 6, Madison, WI 53713 | 2019-11-05 |
| 1942799739 | Emily Natera | Counselor | 128 E. Olin Ave., Ste. 100, Madison, WI 53713 | 2018-05-07 |
| 1295255644 | Renee Denise Wilberg | Counselor | 122 E. Olin Avenue, Madison, WI 53713 | 2017-06-26 |
| 1548793060 | Racquel Williams-kroll | Registered Nurse | 151 East Badger Road Ste A, Madison, WI 53713 | 2017-04-11 |
| 1124570841 | Shirley Norman-johnson | Licensed Practical Nurse | 115 East Badger Rd, Suite A, Madison, WI 53713 | 2016-10-28 |
| 1629525613 | Katherine Simons Melde | Nurse Practitioner | 2222 S Park St Ste 210, Madison, WI 53713 | 2016-09-07 |
| 1013301779 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2840 Index Rd., Madison, WI 53713 | 2015-03-20 |
| 1902147721 | Jill Zimmerman | Occupational Therapy Assistant | 2801 Coho Street, Suite 300, Madison, WI 53713 | 2013-03-04 |
| Find all providers in zip 53713 | ||||
| Taxonomy Code | 207RS0012X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Sleep Medicine |
| An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, www.aasm.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790957371 | Scott E. Johnson | Internal Medicine | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2008-03-24 |
| 1144380577 | Don A Harden | Internal Medicine | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588083307 | Nikhil Samtani | Internal Medicine | 2301 Sun Valley Dr Ste 300, Delafield, WI 53018-2318 | 2014-04-09 |
| 1578829230 | Shane Anton Creado | Internal Medicine | 2727 Marshall Ct, Madison, WI 53705-2255 | 2012-04-07 |
| 1164600490 | Sleep Diagnostic Center LLC | Internal Medicine | 5310 W Capitol Dr, Suite 215, Milwaukee, WI 53216-2263 | 2008-02-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.