Individual provider Active NPI

Jamie Smith

  • Physician Assistant
  • Mt Pleasant, MI
National Provider Identifier
1033742457
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2790 Health Pkwy
Mt Pleasant, MI 48858-6934
Phone
(989) 953-5320
Fax
(989) 953-5329
NPI assigned
Feb 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2790 Health Pkwy
Mt Pleasant, MI 48858-6934

Mailing address

2790 Health Pkwy
Mt Pleasant, MI 48858-6934
Phone (989) 953-5320

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
I20210503000972 MI Practitioner - Physician Assistant 6901215052 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Isabella Citizens for Health, Inc. CurrentSince May 1, 2021 Accepting new patients
Isabella Citizens for Health Inc Current Accepting new patients
Isabella Citizens for Health, Inc. Past Accepting new patients

Locations

2790 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 779-5270

Interoperability endpoints

  • Direct secure messaging: jamie.smith.d1.p1@direct.isabellahealth.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1033742457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488586934",
            "telephone_number": "989-953-5320",
            "fax_number": "989-953-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488586934",
            "telephone_number": "989-953-5320",
            "fax_number": "989-953-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.