NPIMap

Individual provider Active NPI

Jennifer R Wooley, NP

  • Family Nurse Practitioner
  • Taylor, MI
National Provider Identifier
1790939585
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704239555 Issued in MI
Practice address
12701 Telegraph Rd
Suite 103
Taylor, MI 48180-6847
Phone
(734) 374-0500
Fax
(734) 374-2415
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704239555 MI
Family Nurse Practitioner 363LF0000X 4704239555 MI Primary

Addresses

Primary practice location

12701 Telegraph Rd
Suite 103
Taylor, MI 48180-6847

Mailing address

12701 Telegraph Rd
Suite 103
Taylor, MI 48180-6847
Phone (734) 374-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090116000263 MI Practitioner - Nurse Practitioner 5294898235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Feb 1, 2023 Accepting new patients
Iha Health Services Corporation CurrentSince Feb 1, 2023 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Oct 21, 2022 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Oct 21, 2022 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Millennium Medical Group South PC Past Accepting new patients
St Joseph Mercy Hospital PastSince Nov 22, 2011 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients
Satinder Kumar Aggarwal MD P C Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 108
Ypsilanti, MI 48197

Organizations & group practices 9

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.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1790939585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 TELEGRAPH RD",
            "address_2": "SUITE 103",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806847",
            "telephone_number": "734-374-0500",
            "fax_number": "734-374-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 TELEGRAPH RD",
            "address_2": "SUITE 103",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806847",
            "telephone_number": "734-374-0500",
            "fax_number": "734-374-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLEY",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704239555",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704239555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.