Individual provider Active NPI

Jenna L Sommerville-Potter, FNP-BC

  • Nurse Practitioner
  • Keego Harbor, MI
National Provider Identifier
1831077924
Registry record updated Aug 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704375739 Issued in MI
Practice address
1611 Cass Lake Rd Unit D
Keego Harbor, MI 48320-1811
Phone
(248) 762-9950
NPI assigned
Aug 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704375739 MI Primary
Registered Nurse 163W00000X 4704375739 MI

Addresses

Primary practice location

1611 Cass Lake Rd Unit D
Keego Harbor, MI 48320-1811

Mailing address

1611 Cass Lake Rd Unit D
Keego Harbor, MI 48320-1811
Phone (248) 762-9950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704375739MIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756598400000",
    "number": "1831077924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 CASS LAKE RD UNIT D",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201811",
            "telephone_number": "248-762-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 CASS LAKE RD UNIT D",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201811",
            "telephone_number": "248-762-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERVILLE-POTTER",
        "first_name": "JENNA",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-31",
        "certification_date": "2025-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704375739",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704375739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keego Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2025; 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.