Jack A. Kooienga, APRN
NPI 1518216308ActiveIndividual· Nurse Practitioner, Acute Care· Wyoming, MI
Nurse Practitioner, Acute Care (APRN) with Florida Hospital Medical Group Inc and 4 other groups, practicing in Wyoming, Michigan. Enrolled in Medicare as practitioner - nurse practitioner and practitioner - nurse practitioner. Lists Adventhealth Lake Wales and 2 other hospitals as hospital affiliations.
Overview
| NPI | 1518216308 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APRN |
| Sole proprietor | No |
| NPI issued | Sep 7, 2012 |
| Last updated in NPPES | Aug 9, 2021 |
| Certified by provider | Aug 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Acute Care Primary | 363LA2100X | APRN11012762 | FL |
| Nurse Practitioner, Critical Care Medicine | 363LC0200X | 4704218318 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (FL); Practitioner - Nurse Practitioner (MI); Practitioner - Nurse Practitioner (WI) |
|---|
Education and affiliations
| Graduation year | 2003 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical groups
- Florida Hospital Medical Group IncOrlando, FL · 1,755 clinicians
- Intensive Care Consortium IncBrandon, FL · 496 clinicians
- North Michigan Physician Services PCCharlevoix, MI · 67 clinicians
- Wexford Physician Services PCCadillac, MI · 41 clinicians
- Otsego Physician Services PCGaylord, MI · 32 clinicians
Hospital affiliations
- Adventhealth Lake WalesLake Wales, FL
- HCA Florida Lake City HospitalLake City, FL
- Munson Healthcare Cadillac HospitalCadillac, MI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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