Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackie Luthardt, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1679156202

Jackie Luthardt, MD is an Obstetrics/Gynecology in Fond Du Lac, Wisconsin. Graduated from Michigan State University College of Human Medicine in 2021, 5 years ago. Practices with Agnesian Healthcare Inc, a 390-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Trained at
Michigan State University College of Human Medicine
Licensed in
WI
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

420 E Division St
Fond Du Lac, WI 54935-4560
Phone: (920) 926-8450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 600 Highland Ave, Madison, WI 53792-0001 — (608) 263-6400

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 81595-20 (WI)

Record details

NPI number1679156202
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 2, 2021
Last updated in NPPESJuly 31, 2025
Certification dateJuly 31, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated 2021 (5 years in practice)
Group practice Agnesian Healthcare Inc — 390 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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