Judy L Jerome, CGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704120506 Issued in MI

Practice address

829 N Center Ave
Suite 140
Gaylord, MI 49735-1595

Phone

(989) 731-7870

Fax

(989) 731-7837

NPI assigned

May 15, 2006

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1760433577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N. MAIN STREET",
            "address_2": "SUITE 301",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181807",
            "telephone_number": "734-222-8200",
            "fax_number": "734-222-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE",
            "address_2": "SUITE 140",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7870",
            "fax_number": "989-731-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "JUDY",
        "middle_name": "L",
        "credential": "CGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704120506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4874937",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "381303843",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN STATE LICENSE",
            "identifier": "4704120506",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joanne M Jasinski, MA, LPC
• JCS Optical Inc.
• Kathryn A Jeffers, LPN
• Jeffrey WM Katke Owner Great Northern Counseling
• Patrick Alan Johnson, RD, PA-C
• Ashley Jones
• Dawn Michelle Jones, CRNA
• John Paul Jones, PH.D.
• Paige Nicole Jones

• All providers in Gaylord, MI
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.