NPIMap

Individual provider Active NPI

Jenna M McCummings, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Beaverton, MI
National Provider Identifier
1972073807
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704275966 Issued in MI
Practice address
439 S Ross St
Beaverton, MI 48612-9101
Phone
(989) 246-3500
NPI assigned
Dec 4, 2018
Last updated
Aug 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704275966 MI Primary

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 1

  • Jenna M Onweller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190121001187 MI Practitioner - Nurse Practitioner 5496092033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 PCGroup PAC ID 3072684638, 3 clinicians

Practice addresses (Care Compare)

415 W Wackerly St
Midland, MI 48640-2739
Phone (989) 837-6505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704275966MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alpena CurrentSince Aug 25, 2023 Accepting new patients
Renal Associates of Mid-Michigan PC CurrentSince Oct 1, 2021 Accepting new patients
Mymichigan Medical Group CurrentSince Aug 25, 2023 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

  • Direct secure messaging: jenna.mccummings@direct.davitaphysiciansolutions.com
  • Direct secure messaging: jmccummings7281@mymichiganhealth.midirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1972073807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 S ROSS ST",
            "city": "BEAVERTON",
            "state": "MI",
            "postal_code": "486129101",
            "telephone_number": "989-246-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 S ROSS ST",
            "city": "BEAVERTON",
            "state": "MI",
            "postal_code": "486129101",
            "telephone_number": "989-246-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUMMINGS",
        "first_name": "JENNA",
        "middle_name": "M",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704275966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "ONWELLER",
            "middle_name": "M",
            "credential": "AGPCNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaverton, MI

Sources for this page

Verify at the official NPI Registry.