Jessica Renee Samuelson, DNP FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704313451 Issued in MI

Practice address

3400 Fleckenstein Rd
Flint, MI 48507-3042

Phone

(810) 358-2902

NPI assigned

Jul 10, 2019

Last updated

Jun 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Renee Thick Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Specialists of Oakland County PCGroup PAC ID 1153343504, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Orthopedic Specialists of Oakland County, P.C.

  • Orthopaedic Surgery Physician
  • Bloomfield Hills, MI
  • NPI 1720200140
  Medicare reassignment Care Compare group NPD
• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  Medicare reassignment NPD
• Uptiv Health Mi PC

  • Family Nurse Practitioner
  • Westland, MI
  • NPI 1285335265
  Medicare reassignment
• Jawad a Shah MD PC

  • Durable Medical Equipment & Medical Supplies
  • Dearborn, MI
  • NPI 1114667763
  NPD

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

• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1730731829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 FARNSWORTH RD",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484468711",
            "telephone_number": "810-358-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 FLECKENSTEIN RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073042",
            "telephone_number": "810-358-2902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44405 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415023",
            "country_code": "US",
            "telephone_number": "248-294-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "DNP FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704313451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "FLINT",
            "affiliation": "N",
            "address_1": "3400 Fleckenstein Rd",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485073042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "THICK",
            "middle_name": "RENEE",
            "credential": "DNP FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suhana Sammi
• Thomas A Sammon, MSW, LMSW, ACSW
• Tamara Sampson, MA, LLP
• Sams East Inc (Sams Pharmacy 10-8291)
• April L Samuelson
• Alexandra Sanborn, SST
• Sarah R Sanchez, MD
• Christopher Logan Sancraint, MD
• Mona Lee Sander, MSW, LMSW, CAC
• Arianna Sanders

• Family Nurse Practitioner in Flint, MI
• Providers in Flint, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.