Individual provider Active NPI

Jennifer Ann Gole, NP-C

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1962910943
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704225398 Issued in MI
Practice address
1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383
Phone
(616) 685-3450
NPI assigned
Jan 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704225398 MI Primary

Addresses

Primary practice location

1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383

Mailing address

1900 44TH St SE
Kentwood, MI 49508-5008

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
I20180131002373 MI Practitioner - Nurse Practitioner 5799045274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Westshore Cardiology ServicesGroup PAC ID 5991932360, 36 clinicians

Practice addresses (Care Compare)

1000 E Paris Ave SE
Suite 200
Grand Rapids, MI 49546-8383
Phone (616) 685-3450

1212 E Sherman Blvd
Muskegon, MI 49444-1879
Phone (231) 672-3500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Westshore Cardiology Services CurrentSince Sep 1, 2019 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health Saint Mary'S Medical Group Nurse Practitioner CurrentSince Mar 12, 2018 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Mar 12, 2018 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1000 East Paris Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 685-3450

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

1212 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3500

Interoperability endpoints

  • Direct secure messaging: jgole44428@direct.trinity-health.org

Organizations & group practices 4

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 2

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515715200000",
    "number": "1962910943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468383",
            "telephone_number": "616-685-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLE",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704225398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.