Active NPI
Jacqueline Felecia Metzger, N.P.
- Adult Health Nurse Practitioner
- Jackson, MI
National Provider Identifier
1639259757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 4704206804
- Practice address
- 309 Page Ave
Jackson, MI 49201-2419 - Phone
- (517) 787-1234
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704206804 | MI | |
| Acute Care Nurse Practitioner | 363LA2100X | 4704206804 | MI | |
| Adult Health Nurse Practitioner | 363LA2200X | 4704206804 | MI | Primary |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 4704206804 | MI |
Addresses
Primary practice location
309 Page Ave
Jackson, MI 49201-2419
Mailing address
24 Frank Lloyd Wright Dr
PO Box 0446 - Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260128003186 | SD | Practitioner - Nurse Practitioner | 8820028087 | Reassigns benefits to 1 organization |
| I20260520000840 | NC | Practitioner - Nurse Practitioner | 8820028087 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
353 Fairmont Blvd
Rapid City, SD 57701-7375
353 Fairmont Blvd
Rapid City, SD 57701-7393
5221 Paramount Pkwy
Suite 420
Morrisville, NC 27560-4704
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704206804 | MI | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monument Health Rapid City Hospital, Inc | Current | Accepting new patients | |
| Monument Health Rapid City Hospital Inc | Current | Accepting new patients |
Locations
353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Rapid City, SD
- NPI 1275553463
SD
-
- Anesthesiology Physician
- Chapel Hill, NC
- NPI 1780669200
NC
-
- Urgent Care Clinic/Center
- Rapid City, SD
- NPI 1215727854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413936000000",
"number": "1639259757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DR",
"address_2": "PO BOX 0446 - LOBBY J",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059484",
"telephone_number": "734-747-6766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 PAGE AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012419",
"telephone_number": "517-787-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METZGER",
"first_name": "JACQUELINE",
"middle_name": "FELECIA",
"name_prefix": "Mrs.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2014-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704206804",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MI",
"license": "4704206804",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MI",
"license": "4704206804",
"primary": true
},
{
"code": "363LC0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Critical Care Medicine",
"state": "MI",
"license": "4704206804",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.