Jackie Lee Duncan

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704170920 Issued in MI

Practice address

1110 Eldon Baker Dr
Flint, MI 48507-1923

Phone

(810) 232-2766

NPI assigned

Oct 7, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Wayne State University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Easterseals Morc Health Care, Inc 129 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.79 of 100Reported as group

Quality

90.17

Promoting interoperability

83

Improvement activities

40

Cost

86.64

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 and National Provider Directory roles.

• Easterseals Morc Health Care, Inc.

  • Psychiatry Physician
  • Auburn Hills, MI
  • NPI 1376526616

  MI

  Medicare reassignment Care Compare group NPD
• Alternative Community Living, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Saginaw, MI
  • NPI 1114131729

  MI

  Medicare reassignment NPD
• County of Macomb

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton TWP, MI
  • NPI 1942532197

  MI

  Medicare reassignment NPD
• Elan Vitale Healthy Living Solutions

  • Nurse Practitioner
  • Dearborn HTS, MI
  • NPI 1982107140
  NPD (past) Authorized official
• Alternative Community Living, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flint, MI
  • NPI 1144434804
  NPD
• Alternative Community Living, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Flint, MI
  • NPI 1164718441
  NPD
• County of Macomb

  • Public Health or Welfare Agency
  • Mount Clemens, MI
  • NPI 1760462253
  NPD
• Alternative Community Living, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saginaw, MI
  • NPI 1487008652
  NPD (past)

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1740431998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 ELDON BAKER DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071923",
            "telephone_number": "810-232-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ELDON BAKER DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071923",
            "telephone_number": "810-232-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "JACKIE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704170920",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704170920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.essmichigan@direct.mihin.net",
            "affiliation": "Y",
            "affiliationName": "Easterseals MORC Health Care, Inc.",
            "address_1": "2399 E Walton Blvd",
            "city": "Auburn Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483261955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tina Dunavant, LPTA
• Christopher Duncan
• Elonzo Duncan, MSW
• Erica Lynn Duncan
• Howard Duncan, MD
• Quinton Omari Duncan
• Brianna Louise Dunham
• Tara Dunham, BSW
• Ebony Dunigan, LLMFT
• Dwight Dunlap

• All providers in Flint, MI
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.