EVAN JAMES JACKELEN (NPI# 1588152896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588152896 |
| Entity Type | Individual |
| Full Name | EVAN JAMES JACKELEN |
| Practice Address |
3721 Hallie Ln Eau Claire WI 54703-1185 |
| Practice Telephone | 7155339460 |
| Mailing Telephone | 7155339460 |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
3721 HALLIE LN |
| City | EAU CLAIRE |
| State | WI |
| Zip Code | 54703-1185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535929 | Eclipse Counseling LLC | Clinic/Center | 1136 Barron St, Eau Claire, WI 54703 | 2020-07-17 |
| 1982261012 | Melissa Mae Jenneman | Social Worker | 306 Broadway Street, Eau Claire, WI 54703 | 2019-05-23 |
| 1396217014 | Jennifer Grace Joos | Case Manager/Care Coordinator | 2523 Diane Ln, Eau Claire, WI 54703 | 2018-12-19 |
| 1811437346 | Phillip Dolan | Specialist/Technologist | 2801 E Princeton Ave, Eau Claire, WI 54703 | 2017-03-02 |
| 1467830463 | Ryan Behnke | Specialist/Technologist | 725 Hudson St., Eau Claire, WI 54703 | 2015-05-11 |
| 1366737769 | Eric D. Carlson | Dentist | 1020 Menomonie Street, Eau Claire, WI 54703 | 2011-06-14 |
| 1669782587 | Jennifer Jean Andersen | Registered Nurse | 2027 West Ridge Dr., Eau Claire, WI 54703 | 2010-10-13 |
| 1407011257 | Scott R Lau | Hearing Instrument Specialist | 1802 Galloway Street, Eau Claire, WI 54703 | 2008-07-22 |
| 1134316615 | Robert G Grayson | Dentist | 2725 Morningside Dr, Eau Claire, WI 54703 | 2007-09-28 |
| 1689880858 | Okie Earl Allen | Hearing Instrument Specialist | 616 Lamplighter Ct, Eau Claire, WI 54703 | 2007-05-15 |
| Find all providers in zip 54703 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265853998 | Hmong Home Health Care, LLC | Home Health | 2016 Brackett Ave, Eau Claire, WI 54701-4629 | 2013-12-24 |
| 1780921684 | Sunshine Care Personal Care Agency | Home Health | 1101 W Clairemont Ave Ste 1b, Eau Claire, WI 54701-6161 | 2013-01-11 |
| 1821248113 | Healthcorps, Inc. | Home Health | 4316 Oakwood Hills Pkwy Apt 301, Eau Claire, WI 54701-9178 | 2008-09-24 |
| 1437346434 | Lifenet, LLC | Home Health | 800 Wisconsin St Ste 305, Eau Claire, WI 54703-3588 | 2007-10-03 |
| 1467818559 | Safe@home LLC | Home Health | 505 S Dewey St, Ste 106, Eau Claire, WI 54701-3704 | 2016-01-06 |
| 1972752517 | Home Instead Senior Care | Home Health | 515 S Barstow St, Suite 116, Eau Claire, WI 54701-3600 | 2008-09-18 |
| 1609032036 | Eau Claire County Dept of Human Services | Home Health | 721 Oxford Ave, Eau Claire, WI 54703-5212 | 2008-08-05 |
| 1326113952 | Lutheran Social Services of Wisconsin and Upper Michigan, Inc. | Home Health | 1101 W Clairemont Ave, Suite 2g, Eau Claire, WI 54701-4503 | 2006-11-21 |
| 1972521482 | Mayo Clinic Health System-northwest Wisconsin Region, Inc. | Home Health | 200 Spring St, Eau Claire, WI 54703-3469 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245561 | Comfort Care 4 U, LLC | Home Health | 7701 Mineral Point Rd Ste A, Madison, WI 53717-2027 | 2020-11-04 |
| 1639779754 | Wisconsin Independent Living Solutions LLC | Home Health | 817 Colton St, Waukesha, WI 53186-5126 | 2020-10-28 |
| 1821698341 | Jaqualynne Postuchow | Home Health | 8739 Smith St, Sayner, WI 54560-9696 | 2020-10-26 |
| 1467068767 | Lashonda Nicole Simmons | Home Health | 24th Street, 1812 North, Milwaukee, WI 53205-1410 | 2020-09-22 |
| 1124634332 | Nehemiah House, LLC | Home Health | 3901 N 21st Street, Milwaukee, WI 53206 | 2020-09-22 |
| 1699389593 | Infinity Care Services LLC | Home Health | 9203 W Bluemound Rd Ste A, Milwaukee, WI 53226-4484 | 2020-09-08 |
| 1982218426 | Homecare Pal, LLC | Home Health | 2916 Marketplace Dr Ste 209, Fitchburg, WI 53719-5327 | 2020-09-02 |
| 1366053118 | Adron Health Care, LLC | Home Health | 9117 S 20th St, Oak Creek, WI 53154-7465 | 2020-08-14 |
| 1790396521 | Faithful Living Home Health Care Agency LLC | Home Health | 3846 W Wisconsin Ave Apt 110, Milwaukee, WI 53208-3175 | 2020-08-14 |
| 1770194847 | Faithful Hands PCa LLC | Home Health | 8008 W Capitol Dr, Milwaukee, WI 53222-1918 | 2020-08-12 |
| Find all providers with the same taxonomy | ||||
| City | EAU CLAIRE |
| Zip Code | 54703 |
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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.