Individual provider Active NPI

Justice Bockover, FNP

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1669847844
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704250432 Issued in MI
Practice address
601 John St
Suite M-020
Kalamazoo, MI 49007-5341
Phone
(269) 341-8282
Fax
(269) 341-8258
NPI assigned
Dec 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704250432 MI Primary

Addresses

Primary practice location

601 John St
Suite M-020
Kalamazoo, MI 49007-5341

Mailing address

601 John St # 42
Kalamazoo, MI 49007-5341

Other names 1

  • Justice Bockover-Davis Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160127000309 MI Practitioner - Nurse Practitioner 7911200878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

601 John St
Suite 020
Kalamazoo, MI 49007-5381
Phone (269) 341-8282

Hospital & facility affiliations

  • Bronson at Home Healthcare Services Home health agency, Battle Creek, MI, CCN 237028
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704250432MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Mar 1, 2016 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-020
Kalamazoo, MI 49007
Phone (269) 341-8282

601 John St
#2
Kalamazoo, MI 49007

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

Interoperability endpoints

  • Direct secure messaging: jbockover12409@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1669847844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M-020",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8282",
            "fax_number": "269-341-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKOVER",
        "first_name": "JUSTICE",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-14",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704250432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUSTICE",
            "last_name": "BOCKOVER-DAVIS",
            "credential": "MSN,FNP-C.RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.