Individual provider Active NPI

Jill R Schaaf, NP

  • Family Nurse Practitioner
  • Three Rivers, MI
National Provider Identifier
1194490078
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704180286 Issued in MI
Practice address
711 S Health Parkway Ste 1
Three Rivers, MI 49093-8354
Phone
(269) 273-8557
Fax
(269) 279-6461
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704180286 MI Primary

Addresses

Primary practice location

711 S Health Parkway Ste 1
Three Rivers, MI 49093-8354

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

701 S Health Parkway
Three Rivers, MI 49093-8352
Phone (269) 278-1145

Other identifiers 1

IdentifierTypeStateIssuer
1194490078MedicaidMI

Other names 1

  • Jill R Roggelien Former name

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
I20220330000288 MI Practitioner - Nurse Practitioner 2961809090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Rivers Health System IncGroup PAC ID 8729245584, 42 clinicians

Practice addresses (Care Compare)

711 S Health Pkwy
Suite 1
Three Rivers, MI 49093-8354
Phone (269) 273-8557

Hospital & facility affiliations

  • Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Health System, Inc Current Accepting new patients
Three Rivers Health System, Inc CurrentSince Aug 5, 2024 Accepting new patients
Three Rivers Health System, Inc CurrentSince Aug 5, 2024 Accepting new patients
Three Rivers Health Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

711 S Health Parkway
Ste 1
Three Rivers, MI 49093
Phone (269) 273-8557

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1194490078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S HEALTH PARKWAY STE 1",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938354",
            "telephone_number": "269-273-8557",
            "fax_number": "269-279-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 S Health Parkway",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490938352",
            "country_code": "US",
            "telephone_number": "269-278-1145",
            "fax_number": "269-273-9611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAAF",
        "first_name": "JILL",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704180286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194490078",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "ROGGELIEN",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.