SHANNON JACKLIN APNP
NPI 1881464550
Nurse Practitioner - Family in West Bend, WI

Q: What is Shannon Jacklin's NPI number?

The NPI number for Shannon Jacklin is 1881464550. It was assigned to this individual provider in the NPPES registry on January 4, 2024.

Q: What is Shannon Jacklin'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 Shannon Jacklin was last updated on January 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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 January 04, 2024PECOS EnrolledAccepts Medicare Assignment

1700 W PARADISE DR, WEST BEND, WI 53095(262) 384-1555 Get Directions Write a Review

NPPES record last updated: January 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 10, 2025, Jan 4, 2024 (2 updates tracked since 2024).

On this page

About Shannon Jacklin Apnp NPPES

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

SHANNON JACKLIN APNP (NPI 1881464550) is an individual family provider in West Bend, Wisconsin, licensed in Wisconsin (16053-33) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS, is affiliated with St Josephs Community Hospital West Bend, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1881464550

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHANNON JACKLINCredential: APNP

Location Address1700 W PARADISE DRWest Bend, WI 53095-9795

Mailing Address1700 W Paradise DrWest Bend, WI 53095-9795 · (262) 384-1555

Phone(262) 384-1555

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJanuary 4, 2024

Last NPPES UpdateJanuary 13, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2025

✔ NPI 1881464550 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 · 16053-33

1700 W PARADISE DR, West Bend, WI 53095

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Jacklin Apnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850826199

PECOS Enrollment IDI20241125000522

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Josephs Community Hospital West Bend

Acute Care Hospitals · West Bend, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520063

Location3200 Pleasant Valley RoadWest Bend, WI 53095 · Washington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53095 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.

GARY L PREISLER

Family Medicine