Individual provider Active NPI

Jessica Glahn, NP

  • Acute Care Nurse Practitioner
  • Novi, MI
National Provider Identifier
1588230445
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704309510 Issued in MI
Practice address
41850 W 11 Mile Rd
Novi, MI 48375-1819
Phone
(734) 323-3257
NPI assigned
Jun 1, 2021
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704309510 MI Primary

Addresses

Primary practice location

41850 W 11 Mile Rd
Novi, MI 48375-1819

Mailing address

41850 W 11 Mile Rd
Novi, MI 48375-1819
Phone (734) 323-3257

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
I20210712000235 MI Practitioner - Nurse Practitioner 6507268703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

11941 Belsay Rd
Grand Blanc, MI 48439-1702
Phone (810) 694-1970

1330 Grand Pointe CT
Grand Blanc, MI 48439-5502
Phone (810) 695-8920

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704309510MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest H PLLC CurrentSince Aug 14, 2025 Accepting new patients
Theoria Medical CurrentSince Jun 21, 2021 Accepting new patients
Theoria Medical Past Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

11941 Belsay Rd
Grand Blanc, MI 48439
Phone (810) 694-1970

1330 Grand Pointe Ct
Grand Blanc, MI 48439
Phone (810) 344-3518

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

41850 W 11 Mile Rd
Ste 202
Novi, MI 48375
Phone (248) 282-5044

Organizations & group practices 4

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1588230445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41850 W 11 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751819",
            "telephone_number": "734-323-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41850 W 11 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751819",
            "telephone_number": "734-323-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAHN",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704309510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.