Jessica Caulkins, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Hancock, MI
NPI 1316768427 · NPPES record last updated Oct 21, 2024
Key facts
- NPI
- 1316768427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704289460 (MI)
- Practice address
- 500 Campus Dr Ste 4
Hancock, MI 49930-1452 - Phone
- (906) 483-1730
- NPI assigned
- Oct 21, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aspirus Keweenaw
Portage Physician Practices Inc
Practice addresses (Care Compare)
205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100
500 Campus Dr
Hancock, MI 49930-1452
Phone (906) 483-1060
Hospital & facility affiliations
- Up Health System Home Care and Hospice Portage
- Up Health System Portage
- Baraga County Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241113003687 | MI | Practitioner - Nurse Practitioner | 8921532920 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704289460 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portage Physician Practices Inc | Current |
Accepting new patients | |
| Portage Physician Practices Inc | Current |
Accepting new patients |
Locations
500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700
500 Campus Dr
Ste 4
Hancock, MI 49930
Phone (906) 483-1730
500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Interoperability endpoints
- jessica.caulkins.1@8233.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704289460 | MI | Yes |
Addresses
Primary practice location
500 Campus Dr Ste 4
Hancock, MI 49930-1452
Mailing address
929 Evergreen St
Hancock, MI 49930-1103
Phone (517) 425-0100
Other providers in Hancock, MI
- Kelsey Callison
- David John Campain
- Joshua Carlson
- Larry Carroll
- Erin Jeanine Carter
- Ashley Marie Chamberlain
- Sophia Champeau
- Amy Chard
- Vandana Chatterjee
- Jennifer Lynne Cichosz
All providers in Hancock, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.