Individual provider Active NPI

Jennifer Spitz, AGNP

  • Gerontology Nurse Practitioner
  • Mason, MI
National Provider Identifier
1972026912
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704242628 Issued in MI
Practice address
5065 Curtice Rd
Mason, MI 48854-9771
Phone
(517) 575-7997
NPI assigned
Jul 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704242628 MI Primary

Addresses

Primary practice location

5065 Curtice Rd
Mason, MI 48854-9771

Mailing address

5065 Curtice Rd
Mason, MI 48854-9771

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
I20170915001424 MI Practitioner - Nurse Practitioner 8921372830 Reassigns benefits to 3 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
Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

12200 Broadbent Rd
Lansing, MI 48917-9706
Phone (517) 731-6200

5025 Ann Arbor Rd
Jackson, MI 49201-8801
Phone (517) 879-1505

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704242628MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Degara App, PLLC CurrentSince Aug 5, 2018 Accepting new patients
Complexcare Medical Group Midwest H PLLC CurrentSince Jun 10, 2025 Accepting new patients

Locations

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

12200 Broadbent Rd
Lansing, MI 48917
Phone (517) 731-6200

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

9480 E M 21
Ste 200
Ovid, MI 48866
Phone (989) 834-2228

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

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.

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": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500595200000",
    "number": "1972026912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5065 CURTICE RD",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488549771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5065 CURTICE RD",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488549771",
            "telephone_number": "517-575-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPITZ",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-21",
        "last_updated": "2017-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704242628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, MI

Sources for this page

Verify at the official NPI Registry.