Individual provider Active NPI

Jennifer L Simons, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlevoix, MI
National Provider Identifier
1679894117
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704246607 Issued in MI
Practice address
14700 Lake Shore Dr
Charlevoix, MI 49720-1999
Phone
(231) 547-4024
NPI assigned
Jun 18, 2010
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704246607 MI Primary

Addresses

Primary practice location

14700 Lake Shore Dr
Charlevoix, MI 49720-1999

Mailing address

10171 E Shoreside CT
Traverse City, MI 49684-9567

Other practice location 1

3830 W Front St
Traverse City, MI 49684-8153
Phone (231) 935-8101

Other practice location 2

1105 Sixth St
Traverse City, MI 49684-2386
Phone (231) 935-5770 ext. 10

Other identifiers 1

IdentifierTypeStateIssuer
1679894117MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007000798 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042402133 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians
Munson Healthcare CadillacGroup PAC ID 6305161514, 104 clinicians
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1200 6TH St
Traverse City, MI 49684-2369
Phone (231) 935-5800

1465 E Parkdale Ave
Manistee, MI 49660-9709
Phone (231) 398-1000

14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone (231) 547-4024

224 Park Ave
Frankfort, MI 49635-9658
Phone (231) 352-2200

400 Hobart St
Cadillac, MI 49601-2331
Phone (231) 876-3876

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

825 N Ctr Ave
Gaylord, MI 49735-1592
Phone (989) 731-2201

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Charlevoix Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 12, 2022 Accepting new patients
Munson Healthcare Charlevoix Hospital Current Accepting new patients
Munson Medical Group CurrentSince Sep 16, 2022 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Apr 22, 2023 Accepting new patients
Munson Healthcare Charlevoix Hospital Nurse Anesthetist, Certified Registered Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Capital Area Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Munson Medical Center Nurse Anesthetist, Certified Registered CurrentSince Mar 2, 2025 Accepting new patients
Munson Healthcare Cadillac CurrentSince Nov 14, 2022 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Apr 22, 2023 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Healthcare Cadillac Nurse Anesthetist, Certified Registered CurrentSince Nov 14, 2022 Accepting new patients
Munson Medical Group Nurse Anesthetist, Certified Registered CurrentSince Sep 16, 2022 Accepting new patients
Munson Healthcare Charlevoix Hospital CurrentSince Sep 12, 2022 Accepting new patients

Locations

3775 Momentum Pl
Chicago, IL 60689

4880 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Ste 210
Gaylord, MI 49735
Phone (989) 731-7860

2727 S Pennsylvania Ave
Lansing, MI 48910
Phone (517) 975-3750

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

1200 Sixth St
Ste 200
Traverse City, MI 49684

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

4100 Park Forest Dr
Ste 210
Traverse City, MI 49684
Phone (231) 935-5770

Organizations & group practices 16

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.

View all 16

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1679894117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10171 E SHORESIDE CT",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201999",
            "telephone_number": "231-547-4024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 W Front St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496848153",
            "country_code": "US",
            "telephone_number": "231-935-8101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842386",
            "country_code": "US",
            "telephone_number": "231-935-5770 x10",
            "fax_number": "231-935-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704246607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679894117",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.