Individual provider Active NPI

Josephine Anne Vincent, FNP-C

  • Family Nurse Practitioner
  • Gaylord, MI
National Provider Identifier
1487257382
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704272967 Issued in MI
Practice address
1996 Walden Dr
Gaylord, MI 49735-8241
Phone
(989) 731-4111
Fax
(989) 705-8511
NPI assigned
Nov 21, 2020
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704272967 MI Primary

Addresses

Primary practice location

1996 Walden Dr
Gaylord, MI 49735-8241

Mailing address

1996 Walden Dr
Gaylord, MI 49735-8241
Phone (989) 731-4111

Other practice location 1

10215 Ellsworth Rd
East Jordan, MI 49727-9128
Phone (231) 838-7977

Other practice location 2

3860 S Straits Hwy
Indian River, MI 49749-5146
Phone (231) 238-0581

Other practice location 3

3040 Bourn St
Lewiston, MI 49756-8134
Phone (989) 786-4877

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
I20220316000229 MI Practitioner - Nurse Practitioner 5092100784 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704272967MIMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Dec 10, 2021 Accepting new patients
East Jordan Family Health Center Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
East Jordan Family Health Center CurrentSince Oct 2, 2024 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Dec 10, 2021 Accepting new patients

Locations

4955 S M 88 Hwy
Bellaire, MI 49615
Phone (231) 533-8649

601 Bridge St
East Jordan, MI 49727
Phone (231) 536-2206

1996 Walden Dr
Gaylord, MI 49735
Phone (517) 731-4111

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

3040 Bourn St
Lewiston, MI 49756
Phone (989) 731-7777

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: josephine.vincent.p1@direct.ejfhc.nextgenshare.com

Organizations & group practices 5

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": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1487257382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1996 WALDEN DR",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497358241",
            "telephone_number": "989-731-4111",
            "fax_number": "989-705-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1996 WALDEN DR",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497358241",
            "telephone_number": "989-731-4111",
            "fax_number": "989-705-8511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10215 Ellsworth Rd",
            "address_purpose": "LOCATION",
            "city": "East Jordan",
            "state": "MI",
            "postal_code": "497279128",
            "country_code": "US",
            "telephone_number": "231-838-7977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3860 S Straits Hwy",
            "address_purpose": "LOCATION",
            "city": "Indian River",
            "state": "MI",
            "postal_code": "497495146",
            "country_code": "US",
            "telephone_number": "231-238-0581",
            "fax_number": "231-238-0586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3040 Bourn St",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "MI",
            "postal_code": "497568134",
            "country_code": "US",
            "telephone_number": "989-786-4877",
            "fax_number": "989-786-2187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "JOSEPHINE",
        "middle_name": "ANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-21",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704272967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

Verify at the official NPI Registry.