Jillaine Ruppel, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2005010680 Issued in MI

Practice address

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

Phone

(616) 336-3909

Fax

(616) 336-8830

NPI assigned

Aug 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, MO2 enrollments

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 2

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.

• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• County of Macomb

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton TWP, MI
  • NPI 1942532197
  Medicare reassignment NPD
• Kent County CMH Authority

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1588935068
  Medicare reassignment NPD
• CH Specialty Services Mo LLC

  • Internal Medicine Physician
  • Lees Summit, MO
  • NPI 1194422253
  Medicare reassignment NPD
• Curana Health of Missouri-Kansas LLC

  • Family Medicine Physician
  • Lees Summit, MO
  • NPI 1306165337
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008

  Nurse Practitioner

  NPD
• Advantage Health Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• County of Macomb

  • Public Health or Welfare Agency
  • Mount Clemens, MI
  • NPI 1760462253
  NPD
• Kent County CMH Authority

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1194617811
  NPD
• Orthopaedic Associates of Grand Rapids PC

  • Durable Medical Equipment & Medical Supplies
  • Grand Rapids, MI
  • NPI 1740532035
  NPD (past)
• Orthopaedic Associates of Grand Rapids, PC

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
  • NPI 1023021300

  Family

  NPD (past)

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1780816520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Manley St",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494242110",
            "country_code": "US",
            "telephone_number": "616-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUPPEL",
        "first_name": "JILLAINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704225887",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021017489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "2005010680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.network180.x@direct.mihin.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "790 Fuller Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495031918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaylee Ruler
• Jurgen Gernot Runschke, MD
• Aric Anson Runzheimer, MD
• Arnolds Ruperts, LLMSW
• Thomas Rupp, MD
• Walter Erick Rupprecht, D.D.S.
• Caitlin Alexandria Ruprecht, M.S.,CCC-SLP
• Joshua Rusche
• Hayley Morgan Rusco, LLMSW
• Valeri A. Rusco, PAC

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, 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 18, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.