Individual provider Active NPI

Michael Charles McGlynn, CFNP

  • Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1245228709
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704202462 Issued in MI
Practice address
300 W Washington Ave
Ste 150
Jackson, MI 49201-2180
Phone
(517) 783-4664
Fax
(517) 783-4698
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 4704202462 MI Primary

Addresses

Primary practice location

300 W Washington Ave
Ste 150
Jackson, MI 49201-2180

Mailing address

300 W Washington Ave
Ste 150
Jackson, MI 49201-2180
Phone (517) 783-4664

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

LicenseStateTypeSpecialty
4704202462MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John F Smarch DC PC PastSince Mar 1, 2005 Accepting new patients
Donald C Jones MD PC Past Accepting new patients
Rose City Family Practice PC PastSince Jan 16, 1999 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmcglynn468679@direct.hfhs.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245228709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "STE 150",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-783-4664",
            "fax_number": "517-783-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "STE 150",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-783-4664",
            "fax_number": "517-783-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLYNN",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704202462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.