Kathy Jagielo, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704146308 Issued in MI

Practice address

1096 S Belsay Rd
Suite a
Burton, MI 48509-1948

Phone

(810) 742-6100

Fax

(810) 742-1742

NPI assigned

Jan 26, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1487700951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2007",
            "fax_number": "810-743-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 S BELSAY RD",
            "address_2": "SUITE A",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091948",
            "telephone_number": "810-742-6100",
            "fax_number": "810-742-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGIELO",
        "first_name": "KATHY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704146308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4077828",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Burton, MI
• Providers in Burton, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.