Individual provider Active NPI

Jaclyn N Thweatt, CRNA

  • Certified Registered Nurse Anesthetist
  • Grand Blanc, MI
National Provider Identifier
1467096594
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704295540 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 610-9618
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN.468432 OH
Certified Registered Nurse Anesthetist 367500000X 4704295540 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

7156 Manor LN
Fowlerville, MI 48836-9796
Phone (248) 880-2876

Other practice location 1

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

Other identifiers 1

IdentifierTypeStateIssuer
4704295540OtherMILICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210525000516 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486081205 Reassigns benefits to 12 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-6237

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704295540MIMDCertified Registered Nurse Anesthetist
RN.468432OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Clinton Hospital Current Accepting new patients
Jawad a Shah MD PC CurrentSince Nov 15, 2023 Accepting new patients
Covenant Medical Center, Inc CurrentSince Oct 19, 2023 Accepting new patients
Sparrow Eaton Hospital Current Accepting new patients
Ascension Genesys Hospital CurrentSince Jan 1, 2023 Accepting new patients
Jawad a Shah, MD PC CurrentSince Nov 15, 2023 Accepting new patients
Sparrow Eaton Hospital CurrentSince Feb 6, 2025 Accepting new patients
Henry Ford Health Genesys Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2023 Accepting new patients
Sparrow Carson Hospital Nurse Anesthetist, Certified Registered CurrentSince Oct 3, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Dec 25, 2025 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Mar 23, 2025 Accepting new patients
Sparrow Eaton Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 6, 2025 Accepting new patients
Covenant Medical Center, Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 19, 2023 Accepting new patients
Sparrow Clinton Hospital Nurse Anesthetist, Certified Registered CurrentSince Oct 3, 2024 Accepting new patients
Sparrow Clinton Hospital Current Accepting new patients
Anesthesia Associates of Ann Arbor, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2025 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2021 Accepting new patients
Sparrow Clinton Hospital CurrentSince Oct 3, 2024 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients
Alliance Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2023 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Sparrow Carson Hospital CurrentSince Oct 3, 2024 Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered CurrentSince Mar 23, 2025 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

7794 Solution Ctr
Chicago, IL 60677

30400 Telegraph Rd
Ste 405
Bingham Farms, MI 48025
Phone (248) 483-8138

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

111 Lansing St
Ste 110
Charlotte, MI 48813
Phone (517) 541-5855

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Ste 1845
Flint, MI 48507
Phone (810) 275-9152

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

1 Genesys Pkwy
#H
Grand Blanc, MI 48439

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

46325 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 465-1200

46325 W Twelve Mile Rd
Ste 100
Novi, MI 48377
Phone (248) 618-2121

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

230 W Maple Rd
Troy, MI 48084
Phone (248) 244-1500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 3

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": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1467096594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7156 MANOR LN",
            "city": "FOWLERVILLE",
            "state": "MI",
            "postal_code": "488369796",
            "telephone_number": "248-880-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-610-9618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2142 N Cove Blvd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063895",
            "country_code": "US",
            "telephone_number": "419-291-4000",
            "fax_number": "419-479-6905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THWEATT",
        "first_name": "JACLYN",
        "middle_name": "N",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2023-10-18",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.468432",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704295540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704295540",
            "state": "MI"
        }
    ],
    "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 18, 2023; 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.