Individual provider Active NPI

Jaclyn R Miscovich, FNP-BC

  • Family Nurse Practitioner
  • Brentwood, TN
National Provider Identifier
1003475864
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704302387 Issued in MI
Practice address
1642 Westgate Cir Ste 202
Brentwood, TN 37027-8195
Phone
(615) 941-8550
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000025683 TN
Family Nurse Practitioner 363LF0000X 4704302387 MI Primary

Addresses

Primary practice location

1642 Westgate Cir Ste 202
Brentwood, TN 37027-8195

Mailing address

265 Thalia Ave
Rochester Hills, MI 48307-1147
Phone (586) 453-4907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200805002021 MI Practitioner - Nurse Practitioner 7315274115 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

15959 Hall Rd
Suite 104
Macomb, MI 48044-5364
Phone (586) 884-2688

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
25683TNMDDiagnostic Radiology Physician
4704302387MIMDFamily Nurse Practitioner
APN0000025683TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commerce Urgent Care Walk-in Clinic CurrentSince Aug 1, 2020 Accepting new patients
Chesterfield Urgent Care Walk-in Clinic CurrentSince Aug 1, 2020 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince Sep 1, 2021 Accepting new patients
Rochester Urgent Care Walk-in Clinic CurrentSince Aug 1, 2020 Accepting new patients
Canton Urgent Care Walk-in Clinic PC CurrentSince Aug 1, 2020 Accepting new patients
Doctors Urgent Care Southfield CurrentSince Aug 1, 2020 Accepting new patients
Clinton Urgent Care Walk-in Clinic CurrentSince Aug 1, 2020 Accepting new patients
Taylor Urgent Care PC CurrentSince Aug 1, 2020 Accepting new patients
Shelby Urgent Care Walk-in Clinic CurrentSince Aug 1, 2020 Accepting new patients
Troy Urgent Care Walk-in Clinic CurrentSince Aug 1, 2020 Accepting new patients
Sterling Heights Urgent Care Walk-in Clinic CurrentSince Aug 1, 2020 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients
Farmington Hills Urgent Care Walk-in Clinic PC PastSince Jul 31, 2022 Accepting new patients

Locations

43033 Ford Rd
Canton, MI 48187
Phone (734) 927-5050

51160 Gratiot Ave
Chesterfield, MI 48051
Phone (586) 221-1805

37150 S Gratiot Ave
Clinton Twp, MI 48036
Phone (586) 267-1334

2900 Union Lake Rd
Ste 110
Commerce Twp, MI 48382
Phone (248) 242-6049

25950 Middlebelt Rd
Farmington Hills, MI 48336
Phone (248) 803-0672

15959 Hall Rd
Ste 104
Macomb, MI 48044
Phone (586) 884-2688

14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100

2915 Walton Blvd
Rochester Hills, MI 48309
Phone (248) 375-0022

46961 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 991-5205

43722 Schoenherr Rd
Sterling Hts, MI 48313
Phone (586) 262-4277

23234 Ecorse Rd
Taylor, MI 48180
Phone (313) 292-8400

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

4060 Rochester Rd
Troy, MI 48085
Phone (248) 250-6420

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1003475864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 THALIA AVE",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071147",
            "telephone_number": "586-453-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 WESTGATE CIR STE 202",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278195",
            "telephone_number": "615-941-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISCOVICH",
        "first_name": "JACLYN",
        "middle_name": "R",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000025683",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704302387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

Verify at the official NPI Registry.