Individual provider Active NPI

Jean Thayer, FNP-C

  • Family Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1063803542
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704225973 Issued in MI
Practice address
2301 S Huron Pkwy Ste 2B
Ann Arbor, MI 48104-5133
Phone
(734) 725-8802
Fax
(734) 480-8686
NPI assigned
Feb 5, 2015
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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 4704225973 MI Primary

Addresses

Primary practice location

2301 S Huron Pkwy Ste 2B
Ann Arbor, MI 48104-5133

Mailing address

3981 Aberdeen LN
Brighton, MI 48114-8120
Phone (810) 623-4249

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
I20160907000409 MI Practitioner - Nurse Practitioner 4183910896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westlake Consultation CenterGroup PAC ID 4284057662, 9 clinicians

Practice addresses (Care Compare)

2301 S Huron Pkwy
Suite 2B
Ann Arbor, MI 48104-5133
Phone 73472588021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Consultation Center CurrentSince Dec 9, 2020 Accepting new patients

Locations

2301 S Huron Pkwy
Ste 2B
Ann Arbor, MI 48104
Phone (734) 677-0710

4870 W Clark Rd
Ste 100
Ypsilanti, MI 48197
Phone (734) 444-4063

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1063803542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3981 ABERDEEN LN",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481148120",
            "telephone_number": "810-623-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S HURON PKWY STE 2B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045133",
            "telephone_number": "734-725-8802",
            "fax_number": "734-480-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "JEAN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704225973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.