Jennifer D. Eilola, AGNP
Individual provider Active NPI Nurse Practitioner · Marshall, MI
NPI 1114410768 · NPPES record last updated Jun 8, 2018
Key facts
- NPI
- 1114410768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704233225 (MI)
- Practice address
- 215 E Mansion St Ste 3C
Marshall, MI 49068-1167 - Phone
- (269) 789-4386
- NPI assigned
- Jun 8, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Depression Healing Clinic
Supportive Care I of Michigan PC
Practice addresses (Care Compare)
1200 N W Ave
Suite 800
Jackson, MI 49202-2066
Phone (517) 998-4325
330 Lincoln Ave
Iron River, MI 49935-8452
Phone (718) 298-4375
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181002000063 | MI | Practitioner - Nurse Practitioner | 4385995349 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704233225 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.a. Foote Memorial Hospital, Inc | Current |
Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Nurse Practitioner | Current |
Accepting new patients |
| Wa Foote Memorial Hospital, Inc | Nurse Practitioner | Current | Accepting new patients |
| Depression Healing Clinic | Current |
Accepting new patients | |
| Supportive Care I of Michigan PC | Nurse Practitioner | Current |
Accepting new patients |
| Pain Management Group PLLC | Current |
Accepting new patients | |
| Pain Management Group LLC | Nurse Practitioner | Past | Accepting new patients |
Locations
330 Lincoln Ave
Iron River, MI 49935
Phone (810) 445-5300
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
1200 N West Ave
Ste 800
Jackson, MI 49202
Phone (517) 780-3304
813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000
215 E Mansion St
Ste 3C
Marshall, MI 49068
Phone (269) 781-4267
200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921
7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580
27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951
123 E Crawford St
Findlay, OH 45840
Interoperability endpoints
- jeilola455247@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704233225 | MI | Yes |
Addresses
Primary practice location
215 E Mansion St Ste 3C
Marshall, MI 49068-1167
Mailing address
215 E Mansion St Ste 3C
Marshall, MI 49068-1167
Other providers in Marshall, MI
- Dr David R Heidenreich
- Howard Lee Drews III
- Paige Drysdale
- East Marshall LLC
- Angela Lynn Eiler
- Elizabeth Ferrall Consulting LLC
- Ella E M Brown Charitable Circle
- Ella E M Brown Charitable Circle
- Ella E M Brown Charitable Circle
- Ella E M Brown Charitable Circle
All providers in Marshall, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.