Jennifer Gonzalez, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704259119 Issued in MI

Practice address

702 W Lake Lansing Rd
East Lansing, MI 48823-8526

Phone

(517) 332-5342

Fax

(517) 316-2893

NPI assigned

Apr 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Michigan Psychiatric & Primary Care Clinic, PC

  • Clinic/Center
  • East Lansing, MI
  • NPI 1295383909
  Medicare reassignment NPD
• Jjpsychnp Staffing Agency, Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Okemos, MI
  • NPI 1063169860
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1376939926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 BROOKMEAD WAY",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488138717",
            "telephone_number": "269-762-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238526",
            "telephone_number": "517-332-5342",
            "fax_number": "517-316-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704259119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "4704259119",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preeti Gollapalli
• Nora Golper, MA, LPC
• Adam T Gomoll, PA C
• Ashweena Gonuguntla, MD
• Marissa Gonzalez-Jarvi
• Sarah Gonzalez, LMFT
• Kyla Jane Goolsby
• Zoe Gorman
• Ved V Gossain, M.D.
• Timothy Lynn Goth-Owens, PHD

• Psychiatric/Mental Health Nurse Practitioner in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.