Racheal Rose Jamison

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704285557 Issued in MI

Practice address

1979 Holland Ave Ste C
Port Huron, MI 48060-8639

Phone

(810) 982-1200

NPI assigned

Nov 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

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.

• Port Huron Family Care PLLC

  • Primary Care Clinic/Center
  • Port Huron, MI
  • NPI 1518118470
  Medicare reassignment

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1619633625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3648 TEEPLE AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 HOLLAND AVE STE C",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608639",
            "telephone_number": "810-982-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "RACHEAL",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-14",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704285557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Jackson
• Paul Jacobs
• Jane C Jacobson, C.R.N.A.
• Michelle Sue Jahn, PT
• James Fraser DDS PC
• Janet Turner Lomasney, O.D., P.C.
• Andria Laila Janski
• Kristen Ann Janssen, LLMSW
• John Imad Jarad, M.D.
• Kasinadh Jasti, B.PHARM

• Family Nurse Practitioner in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.