Jenna M McCummings, AGPCNP-BC
Individual provider Active NPI Primary Care Nurse Practitioner · Beaverton, MI
NPI 1972073807 · NPPES record last updated Aug 28, 2019
Key facts
- NPI
- 1972073807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 4704275966 (MI)
- Practice address
- 439 S Ross St
Beaverton, MI 48612-9101 - Phone
- (989) 246-3500
- NPI assigned
- Dec 4, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Renal Associates of Mid-Michigan PC
Practice addresses (Care Compare)
415 W Wackerly St
Midland, MI 48640-2739
Phone (989) 837-6505
Hospital & facility affiliations
- Mymichigan Medical Center Midland
- Mymichigan Medical Center Clare
- Mymichigan Medical Center Gladwin
- Mymichigan Medical Center Alpena
- Munson Healthcare Grayling Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190121001187 | MI | Practitioner - Nurse Practitioner | 5496092033 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704275966 | MI | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renal Associates of Mid-Michigan PC | Current |
Accepting new patients | |
| Mymichigan Medical Center Alpena | Current |
Accepting new patients | |
| Mymichigan Medical Group | Current | Accepting new patients | |
| Mymichigan Medical Group | Current |
Accepting new patients |
Locations
609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371
815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096
9249 W Lake City Rd
Houghton Lake, MI 48629
Phone (989) 422-2183
4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956
415 W Wackerly St
Midland, MI 48640
Phone (989) 837-6505
2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660
Interoperability endpoints
- jmccummings7281@mymichiganhealth.midirect.net
- jenna.mccummings@direct.davitaphysiciansolutions.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 4704275966 | MI | Yes |
Addresses
Primary practice location
439 S Ross St
Beaverton, MI 48612-9101
Mailing address
439 S Ross St
Beaverton, MI 48612-9101
Phone (989) 246-3500
Other names
- Jenna M Onweller
Other providers in Beaverton, MI
- Alexander Hull
- Kindling Hope Counseling, PLLC
- Susan M Knoerr
- Arlene Lynn Krager
- Rosemary McCallum-Herbert
- Adrienne McNew
- Mid Michigan Family Eye Care PLLC
- Midmichigan Health Services
- Midmichigan Health Services
- Midmichigan Infusion Care
All providers in Beaverton, MI · Primary Care Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.