Jaclyn Suzette Kournoian, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704234791 Issued in MI

Practice address

1000 Harrington St
Mount Clemens, MI 48043-2920

Phone

(586) 690-9062

NPI assigned

Oct 20, 2009

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 names 1

• Jaclyn Suzette Borowiak Former name

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Physician PartnersGroup PAC ID 8921482605, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkournoian13694@direct.hfhs.org

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.

• Henry Ford Physician Partners

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1427703602
  Medicare reassignment Care Compare group NPD
• Alliance Health Professionals, PLLC

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1841615648
  Medicare reassignment NPD
• Henry Ford Health Macomb Oakland Hospital

  dba Henry Ford Warren Hospital

  • Nurse Practitioner
  • Warren, MI
  • NPI 1578696092
  Medicare reassignment
• Henry Ford Macomb Ancillary Services

  • Clinical Medical Laboratory
  • Mount Clemens, MI
  • NPI 1669864708
  NPD
• Henry Ford Physician Partners

  dba Henry Ford Physician Partners - PCS

  • Cardiovascular Disease Physician
  • Dearborn, MI
  • NPI 1366219651
  NPD
• Internal Medicine Associates of Mt. Clemens, PC

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1306842190
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1386970739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42577 GREYSTONE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483132990",
            "telephone_number": "586-480-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-690-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURNOIAN",
        "first_name": "JACLYN",
        "middle_name": "SUZETTE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704234791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "BOROWIAK",
            "middle_name": "SUZETTE",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zachary Koch, DO
• Patricia Anna Kogut, DPM
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• Sonali Soral Kopke, D.O.
• Vijaya Gopal Kotha, MD
• Peter A Kovalszki, MD
• Benjamin Krater, D.O.
• Krauseneck Chiropractic, PLC
• Barbara Jean Krauseneck, CPNP
• Harold P. Krauseneck, D.D.S.

• Family Nurse Practitioner in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.
• 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.