Active NPI
Jenna Rose Stoddard, FNP
- Family Nurse Practitioner
- Traverse City, MI
National Provider Identifier
1790549327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704330253
- Practice address
- 4100 Park Forest Dr Ste 200
Traverse City, MI 49684-7306 - Phone
- (231) 600-7466
- Fax
- (877) 370-4631
- NPI assigned
- Feb 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4704330253 | MI | |
| Family Nurse Practitioner | 363LF0000X | 4704330253 | MI | Primary |
Addresses
Primary practice location
4100 Park Forest Dr Ste 200
Traverse City, MI 49684-7306
Mailing address
1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-5000
Other practice location 1
1221 Sixth St Ste 100
Traverse City, MI 49684-2359
Phone (231) 935-0322
Other practice location 2
13800 Solon Rd
Traverse City, MI 49684-8558
Phone (231) 590-2890
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Great Lakes Therapy Housecalls PC
Practice addresses (Care Compare)
1221 6TH St
Suite 100
Traverse City, MI 49684-2359
Phone (231) 935-0322
4100 Park Forest Dr
Suite 200
Traverse City, MI 49684-7306
Phone (231) 600-7466
9731 E Cherry Bend Rd
Traverse City, MI 49684-7621
Phone (231) 941-8100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704330253 | MI | MD | Family Nurse Practitioner |
Interoperability endpoints
- jenna.stoddard@novellosc.eclinicaldirectplus.com
Organizations & group practices 2
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.
-
dba Endocrinology and Metabolism
- Endocrinology, Diabetes & Metabolism Physician
- Traverse City, MI
- NPI 1083761860
-
- Multi-Specialty Clinic/Center
- Traverse City, MI
- NPI 1629716964
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Munson Healthcare Cadillac Physician Network
- Family Medicine Physician
- Cadillac, MI
- NPI 1487051611
Hospital
-
- General Acute Care Hospital
- Cadillac, MI
- NPI 1841696754
-
- Rural Acute Care Hospital
- Grayling, MI
- NPI 1083010953
-
- General Acute Care Hospital
- Manistee, MI
- NPI 1407949191
-
- General Acute Care Hospital
- Traverse City, MI
- NPI 1952307852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784160000000",
"number": "1790549327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 SIXTH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842345",
"telephone_number": "231-935-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 PARK FOREST DR STE 200",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847306",
"telephone_number": "231-600-7466",
"fax_number": "877-370-4631"
}
],
"practiceLocations": [
{
"address_1": "1221 Sixth St Ste 100",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496842359",
"country_code": "US",
"telephone_number": "231-935-0322",
"fax_number": "231-935-0334",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13800 Solon Rd",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496848558",
"country_code": "US",
"telephone_number": "231-590-2890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STODDARD",
"first_name": "JENNA",
"middle_name": "ROSE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-13",
"last_updated": "2026-07-16",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4704330253",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704330253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.