Jacqueline N Donovan, NP
Individual provider Active NPI Nurse Practitioner · Curtis, MI
NPI 1366940496 · NPPES record last updated May 11, 2022
Key facts
- NPI
- 1366940496
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704282026 (MI)
- Practice address
- W 17530 Main St
Curtis, MI 49820 - Phone
- (906) 586-3300
- NPI assigned
- Jan 23, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Cincinnati College of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Helen Newberry Joy Hospital
Practice addresses (Care Compare)
502 W Harrie St
Newberry, MI 49868-1209
Phone (906) 293-9200
W17530 Main St
Curtis, MI 49820-9655
Phone (906) 586-3300
Hospital & facility affiliations
- Helen Newberry Joy Hospital
- Schoolcraft 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 |
|---|---|---|---|---|
| I20180507002187 | MI | Practitioner - Nurse Practitioner | 2466716048 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704282026 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helen Newberry Joy Hospital & Healthcare Center | Current | Accepting new patients | |
| Helen Newberry Joy Hospital & Healthcare Center | Current |
Accepting new patients | |
| Helen Newberry Joy Hospital & Healthcare Center | Current |
Accepting new patients | |
| Helen Newberry Joy Hospital & Healthcare Center | Past | Accepting new patients | |
| Superior Health and Wellness PLLC | Past |
Accepting new patients |
Locations
W17530 Main St
Curtis, MI 49820
Phone (906) 293-9248
502 W Harrie St
Newberry, MI 49868
Phone (906) 293-9131
Interoperability endpoints
- jdonovan128872@mymichiganhealth.midirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704282026 | MI | Yes |
Addresses
Primary practice location
W 17530 Main St
Curtis, MI 49820
Mailing address
502 W Harrie St
Newberry, MI 49868
Phone (906) 293-9200
Other providers in Curtis, MI
- Helen Newberry Joy Hospital & Healthcare Center
- Hope on the Horizon- Curtis PLLC
- Lakeview Adult Foster Care Home
- Christopher Rumney
- Township of Portage
All providers in Curtis, MI · 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 May 11, 2022. 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.