MRS. JESSICA HELEN ALTIS (NPI# 1841587029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841587029 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA HELEN ALTIS |
| Other Name | MS. JESSICA HELEN BURKI |
| Credential | PA-C |
| Practice Address |
11211 W Lincoln Ave Lincoln Avenue Clinic West Allis WI 53227-1035 |
| Practice Telephone | 4149555900 |
| Practice Fax Number | 4143277639 |
| Mailing Telephone | 4149555900 |
| Mailing Fax Number | 4143277639 |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2016-02-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
278623 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1841587029 | 05 |
| Street Address |
11211 W LINCOLN AVE LINCOLN AVENUE CLINIC |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-1035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285253609 | Melanie Klawitter | Nurse Practitioner | 11211 W Lincoln Ave, West Allis, WI 53227-1035 | 2020-04-15 |
| 1356820476 | Jaymie Lynn Gehring | Registered Nurse | 11211 W Lincoln Ave, West Allis, WI 53227-1035 | 2018-08-09 |
| 1497280440 | Sally Hartman | Social Worker | 11211 W Lincoln Ave, West Allis, WI 53227-1035 | 2017-04-27 |
| 1154873669 | Alyssa Tennies | Nurse Practitioner | 11211 W Lincoln Ave, West Allis, WI 53227-1035 | 2016-10-31 |
| 1861835365 | Keisha Denise Rogers | Family Medicine | 11211 W Lincoln Ave, West Allis, WI 53227-1035 | 2013-04-15 |
| 1285896340 | Amanda Mae Fuchs | Physician Assistant | 11211 W Lincoln Ave, Lincoln Avenue Clinic, West Allis, WI 53227-1035 | 2008-06-30 |
| 1407899552 | William H Annesley Jr. | Urology | 11211 W Lincoln Ave, Lincoln Avenue Clinic, West Allis, WI 53227-1035 | 2006-06-14 |
| 1770536534 | David E Pryba | Internal Medicine | 11211 W Lincoln Ave, Lincoln Avenue Clinic, West Allis, WI 53227-1035 | 2006-05-19 |
| 1528010238 | Joan L Milott | Internal Medicine | 11211 W Lincoln Ave, Lincoln Avenue Clinic, West Allis, WI 53227-1035 | 2006-05-17 |
| 1598716342 | Michael J Lasser | Obstetrics & Gynecology | 11211 W Lincoln Ave, Lincoln Avenue Clinic, West Allis, WI 53227-1035 | 2006-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093348542 | Christopher Sean Lanctin | Physician Assistant | 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 | 2020-02-12 |
| 1750936068 | Javier Eugenio Font | Physician Assistant | 813 N Clover Ln, Cottage Grove, WI 53527-9433 | 2019-08-04 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1588225544 | Hannah Elizabeth Krum | Physician Assistant | S80w17784 Brennan Dr, Muskego, WI 53150-8828 | 2019-06-21 |
| 1255825162 | Katelyn Marie Frankwick | Physician Assistant | 1011 E Spruce St # 6, Abbotsford, WI 54405-9647 | 2018-06-15 |
| 1831644228 | Megan E Nelson | Physician Assistant | 221 E Mills Dr, Lake Mills, WI 53551-1910 | 2016-08-16 |
| 1356717904 | Amy Hermus | Physician Assistant | 451 Butternut Dr, Oregon, WI 53575-1349 | 2015-08-18 |
| 1497168066 | Alexander J Hill | Physician Assistant | 1111 North Road, Mauston, WI 53948-0700 | 2014-06-11 |
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1386944502 | Bethany Rose Yard | Physician Assistant | 18601 Lincoln Street, Whitehall, WI 54773 | 2010-10-22 |
| Find all providers with the same taxonomy | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
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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.