Individual provider Active NPI

Jessica Lynn Zwolinski, NP

  • Family Nurse Practitioner
  • Caledonia, MI
National Provider Identifier
1619340403
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.17640-NP Issued in OH
Practice address
1661 Crystal Springs Blvd SE
Caledonia, MI 49316-7478
Phone
(616) 326-0114
Fax
(616) 369-3790
NPI assigned
Nov 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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 COA.17640-NP OH Primary

Addresses

Primary practice location

1661 Crystal Springs Blvd SE
Caledonia, MI 49316-7478

Mailing address

1661 Crystal Springs Blvd SE
Suite 150
Caledonia, MI 49316-4461
Phone (616) 326-0114

Other identifiers 1

IdentifierTypeStateIssuer
0158596MedicaidOH

Other names 1

  • Jessica Lynn Schneider Former name

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
I20180427001386 MI Practitioner - Nurse Practitioner 1759687601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derm Institute of West Michigan PLC 9 clinicians

Practice addresses (Care Compare)

1661 Crystal Springs Blvd SE
Caledonia, MI 49316-7478
Phone (616) 326-0114

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Derm Institute of West Michigan PLC CurrentSince Dec 1, 2019 Accepting new patients
Living Well Ohio PastSince Feb 29, 2016 Accepting new patients

Locations

1661 Crystal Springs Blvd SE
Ste 150
Caledonia, MI 49316

1661 Crystal Springs Blvd SE
Caledonia, MI 49316
Phone (616) 326-0114

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00097

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1619340403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 CRYSTAL SPRINGS BLVD SE",
            "address_2": "SUITE 150",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493164461",
            "telephone_number": "616-326-0114",
            "fax_number": "616-369-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 CRYSTAL SPRINGS BLVD SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167478",
            "telephone_number": "616-326-0114",
            "fax_number": "616-369-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWOLINSKI",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.17640-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0158596",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SCHNEIDER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Caledonia, MI

Sources for this page

Verify at the official NPI Registry.