NPI
Jacob Johnson
This page is a copy of the public NPPES file.
Facts
- Status
- Active
- Credential
- D.O.
- Type
- Individual
- Enumeration date
- 2015-06-10
- Last updated
- 2026-03-10
Specialties
Licenses
- License WI
- 71536-21
- License MI
- 5101022137
Location
- Practice location
- 405 Stageline Rd
- City
- Hudson WI
- Postal code
- 54016-7848
- Phone
- (715) 531-6000
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.
Nearby
Other NPIs in Hudson, WI. 851 records in the public file.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.