Jacalyn Meredith Bishop, M.D.

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

4301077893 Issued in MI

Practice address

25500 Meadowbrook Rd
Suite 130
Novi, MI 48375-1878

Phone

(248) 347-3344

Fax

(248) 305-6845

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jacalyn Meredith Lesser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: jbishop58586@direct.hfhs.org

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1063579415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD",
            "address_2": "SUITE 130",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751878",
            "telephone_number": "248-347-3344",
            "fax_number": "248-305-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD",
            "address_2": "SUITE 130",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751878",
            "telephone_number": "248-347-3344",
            "fax_number": "248-305-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "JACALYN",
        "middle_name": "MEREDITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MI",
            "license": "4301077893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519615310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACALYN",
            "last_name": "LESSER",
            "middle_name": "MEREDITH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeremy Dshun Bingham
• Biotech Clinical Laboratories Inc
• Kimberly Birkland
• Kara Dawn Birrell
• Phanie Bish
• Katie Bishop
• Sarah Bishop, OTR/L
• Shanel Bishop
• Amanda Bivins
• Katherine Black

• Pediatric Endocrinology Physician in Novi, MI
• Providers in Novi, MI by specialty
• Pediatric Endocrinology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.