Individual provider Active NPI

Jennifer West, RN

  • Registered Nurse
  • Clinton Township, MI
National Provider Identifier
1972016780
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704314102 Issued in MI
Practice address
42669 Garfield Rd
Clinton Township, MI 48038-1653
Phone
(586) 412-5321
NPI assigned
Nov 15, 2017
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704314102 MI Primary

Addresses

Primary practice location

42669 Garfield Rd
Clinton Township, MI 48038-1653

Mailing address

6549 Town Center Dr Ste a
Clarkston, MI 48346-4824
Phone (248) 620-6400

Other names 1

  • Jennifer Roosa Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704314102MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1972016780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "248-620-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42669 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381653",
            "telephone_number": "586-412-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704314102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROOSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.