NPIMap

Individual provider Active NPI

Jacob Scott Wellnitz, FNP-BC

  • Family Nurse Practitioner
  • Saint Ignace, MI
National Provider Identifier
1700418712
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704311384 Issued in MI
Practice address
1140 N State St
Saint Ignace, MI 49781-1048
Phone
(906) 643-0466
Fax
(906) 643-0414
NPI assigned
Feb 7, 2020
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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 4704311384 MI Primary

Addresses

Primary practice location

1140 N State St
Saint Ignace, MI 49781-1048

Mailing address

2890 Burtch Rd
Grass Lake, MI 49240-9416
Phone (906) 430-7448

Other practice location 1

500 Osborn Blvd
Sault Sainte Marie, MI 49783-1822
Phone (906) 635-4460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200303002394 MI Practitioner - Nurse Practitioner 9133556178 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mackinac Straits Health System IncGroup PAC ID 1456420876, shared by 7 NPIs, 19 clinicians

Practice addresses (Care Compare)

1140 N State St
Saint Ignace, MI 49781-1048
Phone (906) 643-8585

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hawk Emergency Group, P.C. CurrentSince Jun 1, 2024 Accepting new patients
Mackinac Straits Health System Inc Current Accepting new patients
Mymichigan Medical Center Sault Current Accepting new patients
Mymichigan Medical Center Sault CurrentSince Feb 17, 2020 Accepting new patients
Mackinac Straits Health System Inc CurrentSince Nov 17, 2021 Accepting new patients
Mackinac Straits Health System Inc CurrentSince Nov 17, 2021 Accepting new patients
Mymichigan Medical Center Sault CurrentSince Feb 17, 2020 Accepting new patients
Mackinac Straits Health System Inc Past Accepting new patients
Mackinac Straits Hospital Authority Past Accepting new patients
Mackinac Straits Health System Inc Past Accepting new patients

Locations

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

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

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

14540 N Mackinaw Hwy
Mackinaw City, MI 49701
Phone (231) 436-9900

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

1140 N State St
Saint Ignace, MI 49781
Phone (906) 643-0466

509 Osborn Blvd
Sault Sainte Marie, MI 49783
Phone (906) 632-4740

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

Interoperability endpoints

  • Direct secure messaging: jwellnitz128305@mymichiganhealth.midirect.net

Organizations & group practices 11

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.

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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1700418712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 BURTCH RD",
            "city": "GRASS LAKE",
            "state": "MI",
            "postal_code": "492409416",
            "telephone_number": "906-430-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 N STATE ST",
            "city": "SAINT IGNACE",
            "state": "MI",
            "postal_code": "497811048",
            "telephone_number": "906-643-0466",
            "fax_number": "906-643-0414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Osborn Blvd",
            "address_purpose": "LOCATION",
            "city": "Sault Sainte Marie",
            "state": "MI",
            "postal_code": "497831822",
            "country_code": "US",
            "telephone_number": "906-635-4460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLNITZ",
        "first_name": "JACOB",
        "middle_name": "SCOTT",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-07",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704311384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Ignace, MI

Sources for this page

Verify at the official NPI Registry.