Individual provider Active NPI

Jamie J Mulkey, FNP

  • Family Nurse Practitioner
  • West Branch, MI
National Provider Identifier
1285939868
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704214196 Issued in MI
Practice address
621 Court St Ste 104
West Branch, MI 48661-8768
Phone
(989) 701-2293
Fax
(989) 701-2297
NPI assigned
Jan 13, 2011
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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 4704214196 MI Primary

Addresses

Primary practice location

621 Court St Ste 104
West Branch, MI 48661-8768

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3000

Other identifiers 1

IdentifierTypeStateIssuer
4704214196OtherMISTATE LICENSE

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
I20110503000669 MI Practitioner - Nurse Practitioner 0648455816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy IncGroup PAC ID 5698669919, 23 clinicians
Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

3076 Northridge Rd
Hale, MI 48739-9277
Phone (989) 728-0242

621 Court St
Suite 104
West Branch, MI 48661-8768
Phone (989) 701-2993

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704214196MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alpena CurrentSince Dec 12, 2022 Accepting new patients
Northern Michigan Emergency Physicians, LLP Current Accepting new patients
Northern Michigan Emergency Physicians, LLP CurrentSince Feb 18, 2013 Accepting new patients
Mymichigan Medical Group CurrentSince Dec 12, 2022 Accepting new patients
Northern Michigan Emergenc Physicians, LLP CurrentSince Feb 18, 2013 Accepting new patients
Ausable Valley CMH Past Accepting new patients

Locations

602 Beech St
Ste 3100
Clare, MI 48617
Phone (989) 802-5020

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

621 Court St
Ste 104
West Branch, MI 48661
Phone (989) 701-2293

Interoperability endpoints

  • Direct secure messaging: jmulkey131644@mymichiganhealth.midirect.net

Organizations & group practices 7

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 3

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": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1285939868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-839-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 COURT ST STE 104",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486618768",
            "telephone_number": "989-701-2293",
            "fax_number": "989-701-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULKEY",
        "first_name": "JAMIE",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-13",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704214196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4704214196",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

Verify at the official NPI Registry.