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JESSE ELIZABETH CHILDS PA-C
NPI 1104289099
Physician Assistant - Medical in Winnebago, WI

Active since March 30, 2016PECOS Enrolled
1300 SOUTH DRIVE, WINNEBAGO, WI 54985(920) 235-4910 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 5, 2023, Mar 30, 2016 (2 updates tracked since 2016).

About Jesse Elizabeth Childs Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSE ELIZABETH CHILDS PA-C (NPI 1104289099) is an individual medical provider in Winnebago, Wisconsin, licensed in Georgia (7598) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104289099
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJESSE ELIZABETH CHILDSCredential: PA-C
Location Address1300 SOUTH DRIVEWinnebago, WI 54985-5498
Mailing Address12345 Mercy BlvdSaavannah, GA 31419 · (912) 927-3046 · Fax (912) 925-0597
Phone(920) 235-4910
Sole ProprietorNo
Enumeration DateMarch 30, 2016
Last NPPES UpdateJuly 5, 20232 updates tracked since enumeration
NPPES CertifiedJune 26, 2023
✔ NPI 1104289099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in GA · 7598
1300 SOUTH DRIVE, Winnebago, WI 54985
Open in Google Maps ↗

Other Names 1

Former Name (1)Jesse Elizabeth. Dibrell Pa-c

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jesse Elizabeth Childs Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
12 services12 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOUIS M FULTON MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1300 SOUTH DRIVE, WINNEBAGO MENTAL HEALTH INFORMATION
WINNEBAGO, WI 54985
Winnebago County (920) 235-4910
STATE OF WISCONSIN
Psychiatric Hospital
1300 SOUTH DRIVE
WINNEBAGO, WI 54985
Winnebago County (920) 235-4910
DR. KIMBERLY SUE HOENECKE D.O.
Psychiatry & Neurology (Psychiatry)
1300 SOUTH DRIVE
WINNEBAGO, WI 54985
Winnebago County (920) 235-4910
ALEJANDRO A EISMA MD
Internal Medicine
1300 SOUTH DRIVE, WINNEBAGO MENTAL HEALTH INSTITUTE
WINNEBAGO, WI 54985
Winnebago County (920) 235-4910
KONSTANTIN A MIKHEYEV DO
Family Medicine
1300 SOUTH DRIVE
WINNEBAGO, WI 54985
Winnebago County (920) 235-4910
KARIN ZODROW
Nurse Practitioner (Family)
1300 SOUTH DRIVE
WINNEBAGO, WI 54985
Winnebago County (920) 235-4910
CLIFFORD K STEPHENS PH.D
Psychologist (Clinical)
1300 SOUTH DRIVE
WINNEBAGO, WI 54985
Winnebago County (920) 235-4910
JENNIFER PARNELL PA-C
Physician Assistant
1300 SOUTH DRIVE
OSHKOSH, WI 54985
Winnebago County (920) 235-4910

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesse Childs's NPI number?

The NPI number for Jesse Childs is 1104289099. It was assigned to this individual provider in the NPPES registry on March 30, 2016. The provider is also known as Jesse Elizabeth. Dibrell Pa-C.

Where is Jesse Childs located?

Jesse Childs practices at 1300 South Drive, Winnebago, WI 54985. The listed phone number is (920) 235-4910.

What is Jesse Childs's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jesse Childs enrolled in Medicare?

Yes. Jesse Childs is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jesse Childs was last updated on July 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.