Individual provider Active NPI

Jenna Mulder, FNP

  • Family Nurse Practitioner
  • Eaton Rapids, MI
National Provider Identifier
1033933833
Registry record updated Nov 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704357333 Issued in MI
Practice address
1500 S Main St
Eaton Rapids, MI 48827-1952
Phone
(517) 663-2671
NPI assigned
Nov 9, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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 4

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eaton Rapids Medical Center 34 clinicians

Practice addresses (Care Compare)

1500 S Main St
Eaton Rapids, MI 48827-1952

Hospital & facility affiliations

  • Eaton Rapids Medical Center Hospital, Eaton Rapids, MI, CCN 231324
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20250123002666 MI Practitioner - Nurse Practitioner 5294264016 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704357333MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eaton Rapids Medical Center Current Accepting new patients
Eaton Rapids Medical Center CurrentSince Dec 10, 2024 Accepting new patients
Eaton Rapids Medical Center Current Accepting new patients
Eaton Rapids Medical Center CurrentSince Dec 10, 2024 Accepting new patients

Locations

1500 S Main St
Eaton Rapids, MI 48827
Phone (517) 663-2671

400 E Main St
#200
Springport, MI 49284
Phone (517) 857-4500

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704357333 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

1500 S Main St
Eaton Rapids, MI 48827-1952

Mailing address

2357 Pinch Hwy
Charlotte, MI 48813-8776
Phone (517) 242-3382

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 9, 2024.

{
    "created_epoch": "1731110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1033933833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 PINCH HWY",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488138776",
            "telephone_number": "517-242-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "EATON RAPIDS",
            "state": "MI",
            "postal_code": "488271952",
            "telephone_number": "517-663-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "JENNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-09",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704357333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eaton Rapids, MI

Sources for this page

Verify at the official NPI Registry.