Individual provider Active NPI

Jennifer Wawzysko, AGNP-C

  • Primary Care Nurse Practitioner
  • Battle Creek, MI
National Provider Identifier
1467258160
Registry record updated Feb 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704300786 Issued in MI
Practice address
14231 Beadle Lake Rd
Battle Creek, MI 49014-8213
Phone
(269) 962-0441
NPI assigned
Feb 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704300786 MI Primary

Addresses

Primary practice location

14231 Beadle Lake Rd
Battle Creek, MI 49014-8213

Mailing address

31 Mason Ave S
Battle Creek, MI 49037-1611
Phone (269) 753-4092

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
I20250605001992 MI Practitioner - Nurse Practitioner 2062921430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

  • Oaklawn Hospital Hospital, Marshall, MI, CCN 230217
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704300786MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Jun 16, 2025 Accepting new patients
Ella E M Brown Charitable Circle CurrentSince Jun 16, 2025 Accepting new patients
Ella E M Brown Charitable Circle Past Accepting new patients

Locations

14231 Beadle Lake Rd
Battle Creek, MI 49014
Phone (269) 704-5180

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

Interoperability endpoints

  • Direct secure messaging: jennifer.wawzysko.1@9698.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1740182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740182400000",
    "number": "1467258160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MASON AVE S",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490371611",
            "telephone_number": "269-753-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14231 BEADLE LAKE RD",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490148213",
            "telephone_number": "269-962-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAWZYSKO",
        "first_name": "JENNIFER",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-22",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704300786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.