Michelle Nicola Jennings

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

20124 Issued in AZ

Practice address

17674 N Litchfield Rd
Surprise, AZ 85374-2478

Phone

(623) 281-3001

Fax

(480) 906-2180

NPI assigned

Jan 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.jennings@49412312072196.direct.elationemr.com

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.

• Archwell Health Professional Services of Arizona, LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1558026880
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ, Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1515801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1104334077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17674 N LITCHFIELD RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742478",
            "telephone_number": "623-281-3001",
            "fax_number": "480-906-2180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 Ramsey St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283014401",
            "country_code": "US",
            "telephone_number": "910-433-3834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6052 N 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853017709",
            "country_code": "US",
            "telephone_number": "480-618-0176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "MICHELLE",
        "middle_name": "NICOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-13",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "20124",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5010178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle Janssen
• Jocelyn Jasper, OWNER
• Parita Javia
• Stephanie Jenkins, R.N.
• Gretchen Jennings, ED.S
• Jenny V. Wang DDS II, LLC
• Aaron J. Jensen, PA-C
• Danielle Jensen
• Matthew O. Jensen, DMD
• Travis Steven Jensen, DPM

• Adult Health Nurse Practitioner in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.