Individual provider Active NPI

Jennifer Macdougall, RN

  • Registered Nurse
  • Lake City, MI
National Provider Identifier
1699106609
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704293834 Issued in MI
Practice address
724 S Lakeshore Dr
Lake City, MI 49651-9070
Phone
(231) 735-9034
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704293834 MI Primary

Addresses

Primary practice location

724 S Lakeshore Dr
Lake City, MI 49651-9070

Mailing address

724 S Lakeshore Dr
Lake City, MI 49651-9070
Phone (231) 735-9034

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704293834MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1699106609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 S LAKESHORE DR",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496519070",
            "telephone_number": "231-735-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S LAKESHORE DR",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496519070",
            "telephone_number": "231-735-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDOUGALL",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704293834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.