Individual provider Active NPI

Jennifer Rae Jarrell, NP-C

  • Family Nurse Practitioner
  • Grand Haven, MI
National Provider Identifier
1033623699
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704256141 Issued in MI
Practice address
1600 S Beacon Blvd Ste 240
Grand Haven, MI 49417-2654
Phone
(616) 344-1033
NPI assigned
Nov 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704256141 MI Primary

Addresses

Primary practice location

1600 S Beacon Blvd Ste 240
Grand Haven, MI 49417-2654

Mailing address

1600 S Beacon Blvd Ste 240
Grand Haven, MI 49417-2654

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
I20180404001263 MI Practitioner - Nurse Practitioner 0547523565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

1600 S Beacon Blvd
240 Primary Care Grand Haven
Grand Haven, MI 49417-2654
Phone (616) 394-2079

Hospital & facility affiliations

  • Holland Hospital Hospital, Holland, MI, CCN 230072
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704256141MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital CurrentSince Nov 14, 2022 Accepting new patients
Holland Community Hospital CurrentSince Nov 14, 2022 Accepting new patients
Holland Community Hospital Current Accepting new patients
Renae L Crozier Past Accepting new patients
Infusion Associates PLLC PastSince Apr 24, 2015 Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

415 Wiley Rd
Ste 102
Douglas, MI 49406
Phone (269) 857-3208

1600 S Beacon Blvd
Ste 240
Grand Haven, MI 49417
Phone (616) 392-1816

1600 S Beacon Blvd
Grand Haven, MI 49417
Phone (614) 954-0600

577 Michigan Ave
Ste 101
Holland, MI 49423
Phone (616) 393-2190

Interoperability endpoints

  • Direct secure messaging: jennifer.jarrell@holland.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EHGHAD

Organizations & group practices 6

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.

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": "1510963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1033623699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S BEACON BLVD STE 240",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S BEACON BLVD STE 240",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172654",
            "telephone_number": "616-344-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-18",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704256141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.