Jessica Wiemerslage

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087737 Issued in MI

Practice address

4020 Copper VW Ste 104
Traverse City, MI 49684

Phone

(231) 421-6921

Fax

(231) 421-7852

NPI assigned

Feb 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Traverse Health Clinic and Coalition

  • Federally Qualified Health Center (FQHC)
  • Traverse City, MI
  • NPI 1407309685
  NPD
• Traverse Health Clinic and Coalition

  • Federally Qualified Health Center (FQHC)
  • Traverse City, MI
  • NPI 1831866821
  NPD
• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Traverse City, MI
  • NPI 1144645250
  NPD (past)
• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Shelby, MI
  • NPI 1306262258
  NPD (past)

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1497147706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 S AIRPORT RD W",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 COPPER VW STE 104",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-421-6921",
            "fax_number": "231-421-7852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1978 N South Long Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496859097",
            "country_code": "US",
            "telephone_number": "616-808-1267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEMERSLAGE",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Health Care Services Inc
• Charles Whittaker
• Whole Health Regenerative Medicine, PC
• Gregg B Wickstrom, M.D.
• Bridgett Widrig
• Brent M Wiersema, D.O.
• Kristina Kaye Wiersema, LMSW
• Rebecca Louise Wiggins, NP
• Douglas Wigton, DO
• Thomas J. Wigton, CRNA

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.