Active NPI
Judy J Bollstetter, APRN, BC
- Nurse Practitioner
- Saginaw, MI
National Provider Identifier
1326131830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704075682
- Practice address
- 515 N Michigan Ave
Saginaw, MI 48602-4727 - Phone
- (989) 583-2794
- Fax
- (989) 583-2811
- NPI assigned
- Oct 2, 2006
- Last updated
- Sep 12, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704075682 | MI | Primary |
Addresses
Primary practice location
515 N Michigan Ave
Saginaw, MI 48602-4727
Mailing address
515 N Michigan Ave
Saginaw, MI 48602-4316
Phone (989) 583-2794
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 151144 | Other | MI | GREAT LAKES HEALTH PLAN |
| 4704075682 | Other | MI | LICENSE |
| 4775840 | Medicaid | MI | |
| 5008754250 | Other | MI | BCBSM |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704075682 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vpa PC | Past | Accepting new patients | |
| Saginaw Cooperative Hospital Inc | Past | Accepting new patients | |
| Vpa PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hospitalist Physician
- Saginaw, MI
- NPI 1548877434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1326131830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 N MICHIGAN AVE",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486024316",
"telephone_number": "989-583-2794",
"fax_number": "989-583-2811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 N MICHIGAN AVE",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486024727",
"telephone_number": "989-583-2794",
"fax_number": "989-583-2811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLSTETTER",
"first_name": "JUDY",
"middle_name": "J",
"credential": "APRN, BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704075682",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT LAKES HEALTH PLAN",
"identifier": "151144",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "4704075682",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4775840",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "5008754250",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.