Jaclyn Wolf, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704293207 Issued in MI

Practice address

5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346-3199

Phone

(248) 625-2621

Fax

(248) 625-2622

NPI assigned

Jun 14, 2018

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

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

McLaren Community Based Primary Care GroupGroup PAC ID 2466938048, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corsocare Home Health Home health agency, Milford, MI, CCN 239129
• Better You Home Health, LLC Home health agency, Dearborn, MI, CCN 239323
• McLaren Oakland Hospital, Pontiac, MI, CCN 230207
• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaclyn.wolf.1@3928.direct.athenahealth.com

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.

• McLaren Community Based Primary Care Group

  • Physical Medicine & Rehabilitation Physician
  • Flint, MI
  • NPI 1750241816

  Family

  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment Care Compare group NPD
• Northview Medical House Calls PLC

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1336447002
  Medicare reassignment NPD
• McLaren Community Based Primary Care Group

  • Physical Therapist
  • Clarkston, MI
  • NPI 1770448920
  NPD
• Michigan Healthcare Professionals PC

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD

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

• Better You Home Health LLC

  • Home Health Agency
  • Dearborn, MI
  • NPI 1427681246
  Care Compare affiliation
• McLaren Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1376564088
  Care Compare affiliation
• Progress at Home, LLC

  • Home Health Agency
  • Milford, MI
  • NPI 1720212574
  Care Compare affiliation
• St Joseph Mercy Hospital-SMHC

  • 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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1760975635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "JACLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704293207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana Wirth, MA, LPC
• Emily Wisler, LLPC
• Kaitlin N Witherspoon
• Victoria L Wolak, OD
• Sheri Marie Wolcott, DPT
• Tyler Anne Wolfe
• Lisa Ann Wolfgang, PTA
• Taylor Anne Woloszyk, BSN, RN
• Women'S Integrated Health Care, P.C.
• Womens OB/GYN and Bladder Solutions Center, P.C.

• Family Nurse Practitioner in Clarkston, MI
• Providers in Clarkston, 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 Nov 8, 2018; 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.