Individual provider Active NPI

Jonathan Sommers, NP-C

  • Family Nurse Practitioner
  • Kincheloe, MI
National Provider Identifier
1982010864
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704305723 Issued in MI
Practice address
16523 S Water Tower Dr
Kincheloe, MI 49788-1592
Phone
(906) 495-1344
Fax
(906) 495-1403
NPI assigned
Jul 11, 2014
Last updated
Jul 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704305723 MI Primary

Addresses

Primary practice location

16523 S Water Tower Dr
Kincheloe, MI 49788-1592

Mailing address

16523 S Water Tower Dr
Kincheloe, MI 49788-1592
Phone (906) 495-1344

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
I20140813002079 MI Practitioner - Nurse Practitioner 1355568437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center SaultGroup PAC ID 7315936481, 101 clinicians

Practice addresses (Care Compare)

500 Osborn Blvd
Sault S Marie, MI 49783-1822
Phone (906) 635-4460

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704305723MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Sault Current Accepting new patients
Lake Superior State University CurrentSince Mar 9, 2021 Accepting new patients
Mymichigan Medical Center Sault CurrentSince Jan 15, 2015 Accepting new patients
Mymichigan Medical Center Sault CurrentSince Jan 15, 2015 Accepting new patients
Mymichigan Medical Center Sault Past Accepting new patients

Locations

16523 S Water Tower Dr
Kincheloe, MI 49788
Phone (906) 495-1344

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

621 W Easterday Ave
Sault South Marie, MI 49783
Phone (906) 635-2110

650 W Easterday Ave
Sault South Marie, MI 49783
Phone (906) 635-2110

Interoperability endpoints

  • Direct secure messaging: jsommers142395@mymichiganhealth.midirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1982010864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16523 S WATER TOWER DR",
            "city": "KINCHELOE",
            "state": "MI",
            "postal_code": "497881592",
            "telephone_number": "906-495-1344",
            "fax_number": "906-495-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16523 S WATER TOWER DR",
            "city": "KINCHELOE",
            "state": "MI",
            "postal_code": "497881592",
            "telephone_number": "906-495-1344",
            "fax_number": "906-495-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERS",
        "first_name": "JONATHAN",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704305723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kincheloe, MI

Sources for this page

Verify at the official NPI Registry.