Jacqueline Stewart, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704304212 Issued in MI

Practice address

905 E Colby St
Whitehall, MI 49461-1262

Phone

(231) 672-8050

Fax

(231) 672-8048

NPI assigned

Jul 26, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Somerville Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synanon IncGroup PAC ID 6204899172, 7 clinicians

Mercy Health PartnersGroup PAC ID 1456430016, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320
• Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsomerville208096@direct.trinity-health.org
• Direct secure messaging: jacqueline.stewart.1@22386.direct.athenahealth.com

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.

• Mercy Health Partners

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  Medicare reassignment Care Compare group NPD
• Synanon Inc

  • Urgent Care Clinic/Center
  • Grand Haven, MI
  • NPI 1588650261
  Medicare reassignment Care Compare group NPD
• Lake Michigan Emergency Specialists, PLLC

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1124574520
  Medicare reassignment NPD
• Mercy Health Partners

  • Rural Health Clinic/Center
  • Whitehall, MI
  • NPI 1326463357
  NPD

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

• Mercy Health Partners

  • Critical Access Hospital
  • Shelby, MI
  • NPI 1285662981
  Care Compare affiliation
• Trinity Health Grand Haven Hospital

  • General Acute Care Hospital
  • Grand Haven, MI
  • NPI 1942379284
  Care Compare affiliation

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1952955098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431848",
            "telephone_number": "231-672-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E COLBY ST",
            "city": "WHITEHALL",
            "state": "MI",
            "postal_code": "494611262",
            "telephone_number": "231-672-8050",
            "fax_number": "231-672-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JACQUELINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704304212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsomerville208096@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Health Partners",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "office",
            "address_1": "905 E Colby St",
            "city": "Whitehall",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494611262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "SOMERVILLE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shoreline Therapy Services, PLLC
• Melissa Lynn Sias, LMSW
• Amy Susan Simpson, LMSW
• Lee Alan Smith
• Frank Edward Staab, LLPC
• Robert Swiatek, LMSW
• Dannie L Tabor, D.O.
• Jacob Marshall Taylor, D.O., M.P.H.
• Joseph Christian Thompson, LLC
• Elizabeth A Tree-Levasseur, M.D.

• Family Nurse Practitioner in Whitehall, MI
• Providers in Whitehall, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.

Verify at the official NPI Registry.