JACKLYN M SPATES APNP
NPI 1487969572
Nurse Practitioner - Family in Appleton, WI

Q: What is Jacklyn Spates's NPI number?

The NPI number for Jacklyn Spates is 1487969572. It was assigned to this individual provider in the NPPES registry on August 12, 2010.

Q: What is Jacklyn Spates's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jacklyn Spates was last updated on May 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since August 12, 2010PECOS Enrolled

820 E GRANT ST, SUITE 230, APPLETON, WI 54911(920) 738-7300(920) 738-7301 Get Directions Write a Review

NPPES record last updated: May 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jacklyn M Spates Apnp NPPES

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

JACKLYN M SPATES APNP (NPI 1487969572) is an individual family provider in Appleton, Wisconsin, licensed in Wisconsin (4125) and active in the NPI registry since August 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487969572

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJACKLYN M SPATESCredential: APNP

Location Address820 E GRANT ST, SUITE 230Appleton, WI 54911-3483

Mailing Address2500 Overlook Ter, Suite 230Madison, WI 53705-2254 · (608) 256-1901

Phone(920) 738-7300

Fax(920) 738-7301

Sole ProprietorNo

Enumeration DateAugust 12, 2010

Last NPPES UpdateMay 23, 2016

✔ NPI 1487969572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in WI · 4125

820 E GRANT ST, Appleton, WI 54911

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacklyn M Spates Apnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54911 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MRS. KATHERINE K KRAUSE PA

Physician Assistant