NPIMap

Individual provider Active NPI

Mary Elizabeth Jacobs, NP-C

  • Family Nurse Practitioner
  • Holt, MI
National Provider Identifier
1841622826
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704234599 Issued in MI
Practice address
4221 Charlar Dr
Holt, MI 48842-6804
Phone
(517) 694-7600
NPI assigned
Aug 1, 2013
Last updated
Aug 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704234599 MI Primary

Addresses

Primary practice location

4221 Charlar Dr
Holt, MI 48842-6804

Mailing address

4221 Charlar Dr
Holt, MI 48842-6804

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
I20131030001717 MI Practitioner - Nurse Practitioner 7113152091 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2909 E Grand River Ave
302 SMG North
Lansing, MI 48912-4335
Phone (517) 364-8680

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704234599MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital Current Accepting new patients
Sparrow Ionia Hospital CurrentSince Dec 1, 2024 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients
Sparrow Carson Hospital CurrentSince Dec 1, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Dec 1, 2024 Accepting new patients
Sparrow Ionia Hospital Family CurrentSince Dec 1, 2024 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Jun 1, 2014 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

102 S 3rd St
Ste 100
Carson City, MI 48811
Phone (989) 584-1308

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1004 E Michigan Ave
Lansing, MI 48912
Phone (517) 364-9790

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

2909 E Grand River Ave
Ste 302
Lansing, MI 48912
Phone (517) 337-8680

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1841622826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 CHARLAR DR",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488426804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 CHARLAR DR",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488426804",
            "telephone_number": "517-694-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704234599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holt, MI

Sources for this page

Verify at the official NPI Registry.