Active NPI
Nicole L Reul
- Physician Assistant
- Jackson, MI
National Provider Identifier
1659382265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003752
- Practice address
- 300 W Washington Ave
Jackson, MI 49201-2180 - Phone
- (517) 783-4664
- Fax
- (517) 783-4698
- NPI assigned
- Aug 10, 2006
- Last updated
- Mar 7, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003752 | MI | Primary |
Addresses
Primary practice location
300 W Washington Ave
Jackson, MI 49201-2180
Mailing address
10853 State Rd
Rives Junction, MI 49277-9736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601003752 | Other | MI | STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003752 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Michigan Family Care PLC | Past | Accepting new patients | |
| John F Smarch DC PC | Past | Accepting new patients | |
| Provisions Health | Past | Accepting new patients | |
| Rose City Family Practice PC | Past | Accepting new patients |
Interoperability endpoints
- nreul462847@direct.hfhs.org
Organizations & group practices 4
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.
-
dba East Michigan Family Care
- Family Medicine Physician
- Lansing, MI
- NPI 1124135116
-
- Chiropractor
- Jackson, MI
- NPI 1174727341
-
- Family Medicine Physician
- Jackson, MI
- NPI 1952498685
-
- Family Medicine Physician
- Eau Claire, WI
- NPI 1508875840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1659382265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10853 STATE RD",
"city": "RIVES JUNCTION",
"state": "MI",
"postal_code": "492779736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W WASHINGTON AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012180",
"telephone_number": "517-783-4664",
"fax_number": "517-783-4698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REUL",
"first_name": "NICOLE",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003752",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "5601003752",
"state": "MI"
}
],
"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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.