Jenna Revelle Thomas, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704273322 Issued in MI

Practice address

1701 South Blvd E Ste 190
Rochester Hills, MI 48307-6124

Phone

(248) 289-1509

NPI assigned

Sep 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jthomas1979598@direct.trinity-health.org
• Direct secure messaging: jthomas687307@direct.hfhs.org

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1649940198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE 190",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076124",
            "telephone_number": "248-289-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE 190",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076124",
            "telephone_number": "248-289-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JENNA",
        "middle_name": "REVELLE",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704273322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "endpointDescription": "Epic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "epic",
            "address_1": "1701 South Blvd E Ste 190",
            "city": "Rochester Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483076124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas R Perkins DO PLC
• Danielle Nicole Thomas
• Jacob Thomas, DC
• James P Thomas, DDS
• James Philip Thomas Jr., D.D.S
• Pamela Nicole Thomas, M.S., PA-C
• Sean Christopher Thomas, DMD
• Stephanie Martha Thomas
• Bryn Elizabeth Thompson, PA-C
• Elizabeth Cole Thompson, PMHNP

• Acute Care Nurse Practitioner in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.