Northwestern Michigan College

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

License

4704147470 Issued in MI

Legal business name

NORTHWESTERN MICHIGAN COLLEGE

Practice address

1701 E Front St
L.B. 106
Traverse City, MI 49686-3016

Phone

(231) 995-1255

Fax

(231) 995-1923

NPI assigned

Aug 20, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Renee Rose Jacobson, F.N.P.NPI 1619196490

Title

Director of Health Services

Phone

(231) 995-1256

Specialties & licenses 1

Addresses

Other names 1

• Northwestern Michigan College Student Health Services Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renee Rose Jacobson, FNP

  • Family Nurse Practitioner
  • Traverse City, MI
  • NPI 1619196490
  NPD (past) Authorized official

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1700033859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E FRONT ST",
            "address_2": "L.B. 106",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863016",
            "telephone_number": "231-995-1255",
            "fax_number": "231-995-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E FRONT ST",
            "address_2": "L.B. 106",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863016",
            "telephone_number": "231-995-1255",
            "fax_number": "231-995-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MICHIGAN COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SERVICES",
        "authorized_official_telephone_number": "231-995-1256",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "F.N.P."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "MI",
            "license": "4704147470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Michigan College Student Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northwest Michigan Health Services, Inc.
• Northwest Michigan Heart & Vascular Specialists
• Northwest Michigan Surgery Center LLC
• Northwest Michigan Surgical Group, P.C.
• Northwest Senior Resources Incorporated
• Northwestern Michigan Dermatology
• Northwestern Michigan Dermatology PC
• Northwestern Michigan Emergency Physicians PC
• Northwestern Michigan Neonatology
• Northwood Cosmetic Dental Group, PC

• All providers in Traverse City, MI
• Student Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.