Jan Hazel Prokosch, FNPC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704215502 Issued in MI

Practice address

1500 Sandpoint Rd
Munising, MI 49862-1406

Phone

(906) 387-4110

Fax

(906) 387-3514

NPI assigned

Jun 24, 2006

Last updated

Nov 30, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, IN, OH, NY, WI5 enrollments

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 5

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Hospital

  • Critical Access Hospital
  • Iron River, MI
  • NPI 1497750830
  Medicare reassignment NPD
• Baraga County Memorial Hospital

  • Critical Access Hospital
  • L'Anse, MI
  • NPI 1558479824
  Medicare reassignment NPD
• Baraga County Memorial Hospital

  dba BCMH Physician Group

  • Family Medicine Physician
  • L'Anse, MI
  • NPI 1851409643
  Medicare reassignment NPD
• Northern Michigan Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Escanaba, MI
  • NPI 1417972183

  Nurse Practitioner

  Medicare reassignment NPD
• Hometown Urgent Care of Michigan, P.C.

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385

  MI

  Medicare reassignment NPD
• Pic Indiana PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment NPD
• Wellnow Urgent Care, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162
  Medicare reassignment NPD
• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Clinic

  • Rural Health Clinic/Center
  • Iron River, MI
  • NPI 1306344783
  NPD
• Baraga County Memorial Hospital

  • Emergency Medicine Physician
  • L'Anse, MI
  • NPI 1508960600
  NPD
• Baraga County Memorial Hospital

  dba Baraga County Home Care & Hospice

  • Home Health Agency
  • L'Anse, MI
  • NPI 1932218807
  NPD
• Hometown Urgent Care of Michigan, P.C.

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Hometown Urgent Care of Michigan, PC

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1881358489
  NPD

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1639105372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SANDPOINT RD",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621406",
            "telephone_number": "906-387-4110",
            "fax_number": "906-387-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SANDPOINT RD",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621406",
            "telephone_number": "906-387-4110",
            "fax_number": "906-387-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOSCH",
        "first_name": "JAN",
        "middle_name": "HAZEL",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704215502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5008770770",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Kurt Olson, CNP
• Heather Palmer
• Pathways Community Mental Health
• Victor Adam Patronik, D.D.S.
• Kerrie Phillipson
• Emily Rose Prunick, FNP-C
• Putvin Health Mart of Munising Inc (Putvin Drug Store A Radio Shack Dealer)
• Chelsea Elise Ray, MD
• Nicole Roth, PA
• Walter William Rudzinski, MD

• Nurse Practitioner in Munising, MI
• Providers in Munising, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.