Individual provider Active NPI

Monique N Jones, MSN, RN, FNP-C

  • Family Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1861902322
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704242970 Issued in MI
Practice address
30920 Southfield Rd
Southfield, MI 48076-7738
Phone
(248) 647-6558
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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 4704242970 MI
Family Nurse Practitioner 363LF0000X 4704242970 MI Primary

Addresses

Primary practice location

30920 Southfield Rd
Southfield, MI 48076-7738

Mailing address

7030 Helen St
Garden City, MI 48135-2211
Phone (248) 943-8701

Other practice location 1

2850 S Industrial Hwy
Ann Arbor, MI 48104-6796
Phone (734) 477-7298

Other practice location 2

30700 Telegraph Rd
Bingham Farms, MI 48025-4524
Phone (248) 480-4440

Other practice location 3

13240 Woodrow Wilson St
Detroit, MI 48238-3692
Phone (248) 943-8701

Other names 1

  • Monique Fuller Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200608002906 MI Practitioner - Nurse Practitioner 5294156709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

5901 W Century Blvd
Suite 750
Los Angeles, CA 90045-5443

7030 Helen St
Garden City, MI 48135-2211

745 McClintock Dr
Suite 360
Burr Ridge, IL 60527-0853

PO Box
Suite 772
Woonsocket, RI 02895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704242970MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Global Wound Care Medical Group CurrentSince Jun 21, 2023 Accepting new patients
Paragon Clinical LLC Family CurrentSince May 18, 2020 Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

1385 E Empire Ave
Benton Harbor, MI 49022
Phone (269) 925-0033

7633 E Jefferson Ave
Ste 110
Detroit, MI 48214
Phone (858) 256-1243

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1861902322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 HELEN ST",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352211",
            "telephone_number": "248-943-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30920 SOUTHFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480767738",
            "telephone_number": "248-647-6558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 S Industrial Hwy",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481046796",
            "country_code": "US",
            "telephone_number": "734-477-7298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30700 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Bingham Farms",
            "state": "MI",
            "postal_code": "480254524",
            "country_code": "US",
            "telephone_number": "248-480-4440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13240 Woodrow Wilson St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482383692",
            "country_code": "US",
            "telephone_number": "248-943-8701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "MONIQUE",
        "middle_name": "N",
        "credential": "MSN, RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704242970",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704242970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONIQUE",
            "last_name": "FULLER",
            "credential": "MSN, RN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.