Individual provider Active NPI

Jessie Page Hart

  • Gerontology Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1467169748
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704342268 Issued in MI
Practice address
2282 Springport Rd
Jackson, MI 49202-1432
Phone
(517) 768-9791
NPI assigned
Nov 4, 2022
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704342268 MI Primary

Addresses

Primary practice location

2282 Springport Rd
Jackson, MI 49202-1432

Mailing address

10151 N Adams Rd
North Adams, MI 49262-9740
Phone (517) 425-1212

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230217001036 MI Practitioner - Nurse Practitioner 4587036603 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704342268MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Health Medical Mi PC CurrentSince Dec 29, 2024 Accepting new patients
Hillsdale Community Health Center CurrentSince Nov 17, 2022 Accepting new patients

Locations

3011 N Center Rd
Flint, MI 48506
Phone (710) 736-0600

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

240 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-7040

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

Interoperability endpoints

  • Direct secure messaging: jhart824532@direct.hfhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1467169748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 N ADAMS RD",
            "city": "NORTH ADAMS",
            "state": "MI",
            "postal_code": "492629740",
            "telephone_number": "517-425-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2282 SPRINGPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021432",
            "telephone_number": "517-768-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JESSIE",
        "middle_name": "PAGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704342268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.