Active NPI
Jasper Mukwada, FNP
- Family Nurse Practitioner
- Kalamazoo, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71008591A
- Practice address
- 601 John St
Box 74
Kalamazoo, MI 49007-5341 - Phone
- (269) 341-8481
- Fax
- (269) 341-7781
- NPI assigned
- Aug 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704274083 | MI | |
| Family Nurse Practitioner | 363LF0000X | 71008591A | IN | Primary |
Addresses
Primary practice location
601 John St
Box 74
Kalamazoo, MI 49007-5341
Mailing address
601 John St
Box 74
Kalamazoo, MI 49007-5341
Phone (269) 341-8481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71008591A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiant Star LLC | Current | Accepting new patients | |
| Bronson Lakeview Hospital | Current | Accepting new patients | |
| Signify Health Medical Associates, PLLC | Current | Accepting new patients | |
| Bronson Lakeview Hospital | Current | Accepting new patients | |
| JD Cares LLC | Current | Accepting new patients | |
| Bronson Methodist Hospital | Current | Accepting new patients | |
| Zimshine LLC | Current | Accepting new patients | |
| Aims, LLC | Current | Accepting new patients |
Locations
417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330
9330 Broadway
Crown Point, IN 46307
Phone (219) 648-2400
1625 E Jefferson Blvd
Mishawaka, IN 46545
Phone (219) 257-2295
601 John St
#74
Kalamazoo, MI 49007
Phone (269) 341-8481
601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500
451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725
13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- jasper.mukwada.1@28492.direct.athenahealth.com
Organizations & group practices 8
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.
-
dba Bronson Medical Group
- Internal Medicine Physician
- Paw Paw, MI
- NPI 1235131137
-
dba Bronson Medical Group
- Hospitalist Physician
- Kalamazoo, MI
- NPI 1417961137
-
- Psychiatry Physician
- Bremen, IN
- NPI 1376072785
-
- Custodial Care Facility
- Battle Creek, MI
- NPI 1376331256
-
- Adult Care Home Facility
- Battle Creek, MI
- NPI 1447896790
-
- Adult Care Home Facility
- Kalamazoo, MI
- NPI 1366175523
-
dba Bronson LakeView Family Care-Blue Star
- Rural Health Clinic/Center
- South Haven, MI
- NPI 1801538871
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630627200000",
"number": "1558815787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "BOX 74",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-341-8481",
"fax_number": "269-341-7781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "BOX 74",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-341-8481",
"fax_number": "269-341-7781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKWADA",
"first_name": "JASPER",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-04",
"last_updated": "2021-09-03",
"certification_date": "2021-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704274083",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71008591A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.