Active NPI
Jennifer Stockwell
- Funeral Director
- New Buffalo, MI
National Provider Identifier
1124659248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Funeral Director
- License
- 4501008202
- Practice address
- 447 S Whittaker St
New Buffalo, MI 49117-1763 - Phone
- (844) 214-4446
- NPI assigned
- Jan 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Funeral Director | 176P00000X | 4501008202 | MI | Primary |
Addresses
Primary practice location
447 S Whittaker St
New Buffalo, MI 49117-1763
Mailing address
2418 W Bloomingdale Ave Ste C2
Chicago, IL 60647-4368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4501008202 | MI | MD | Funeral Director |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1124659248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2418 W BLOOMINGDALE AVE STE C2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606474368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "447 S WHITTAKER ST",
"city": "NEW BUFFALO",
"state": "MI",
"postal_code": "491171763",
"telephone_number": "844-214-4446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCKWELL",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-28",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "176P00000X",
"taxonomy_group": "",
"desc": "Funeral Director",
"state": "MI",
"license": "4501008202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Buffalo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.