Jennifer Massarelli, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704344082 Issued in MI

Practice address

2215 Fuller Rd
Ann Arbor, MI 48105-2303

Phone

(734) 769-7100

NPI assigned

Mar 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Ms. Jennifer Hall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1093057580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "UMASS MEMORIAL MEDICAL CENTER, PSYCHIATRY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3562",
            "fax_number": "508-421-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-769-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSARELLI",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "276298",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN276298",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704344082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "276298",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704344082",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HALL",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amelita Anne Maslach, MD
• Amber Nicole Mason-Noble, NP
• Bailey Mason
• Meredith L Mason
• Suzanne Anderson Mason, D.D.S.
• Ryan Massay, MD
• Daniel Masserang, NP
• Cassidy Rae Masserant
• John F Masserant, CRNA
• Mona Massoud

• Psychiatric/Mental Health Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.