Individual provider Active NPI

Jillian Lee Mogerman, NP

  • Nurse Practitioner
  • Ludington, MI
National Provider Identifier
1114512191
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704307282 Issued in MI
Practice address
5656 W US Highway 10
Ludington, MI 49431-2454
Phone
(231) 316-1017
NPI assigned
Mar 2, 2021
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704307282 MI Primary

Addresses

Primary practice location

5656 W US Highway 10
Ludington, MI 49431-2454

Mailing address

5656 W US Highway 10
Ludington, MI 49431-2454
Phone (231) 316-1017

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
I20231222000511 MI Practitioner - Nurse Practitioner 9032569637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health PartnersGroup PAC ID 1456430016, 65 clinicians

Practice addresses (Care Compare)

5656 W US Hwy 10
Ludington, MI 49431-2454
Phone (231) 316-1014

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners CurrentSince Jan 2, 2024 Accepting new patients
Mercy Health Partners CurrentSince Jan 2, 2024 Accepting new patients

Locations

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

Interoperability endpoints

  • Direct secure messaging: jmogerman3132552@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1114512191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 W US HIGHWAY 10",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312454",
            "telephone_number": "231-316-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 W US HIGHWAY 10",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312454",
            "telephone_number": "231-316-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGERMAN",
        "first_name": "JILLIAN",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704307282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.