Individual provider Active NPI

Jessica Emmons

  • Certified Registered Nurse Anesthetist
  • Grand Blanc, MI
National Provider Identifier
1356089403
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704260116 Issued in MI
Practice address
6096 Fountain Pointe
Grand Blanc, MI 48439-7751
Phone
(810) 691-8899
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704260116 MI Primary

Addresses

Primary practice location

6096 Fountain Pointe
Grand Blanc, MI 48439-7751

Mailing address

6096 Fountain Pointe
Grand Blanc, MI 48439-7751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241017004217 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658803465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians

Practice addresses (Care Compare)

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-9353

Hospital & facility affiliations

  • Hurley Medical Center Hospital, Flint, MI, CCN 230132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates Inc PC Current Accepting new patients
Hurley Medical Center Nurse Anesthetist, Certified Registered CurrentSince Oct 28, 2024 Accepting new patients
Hurley Medical Center CurrentSince Oct 28, 2024 Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

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.

Hospital & facility affiliations 1

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1356089403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6096 FOUNTAIN POINTE",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6096 FOUNTAIN POINTE",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397751",
            "telephone_number": "810-691-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704260116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.