Individual provider Active NPI

Edward Corey Christenson, PA-C

  • Physician Assistant
  • Southfield, MI
National Provider Identifier
1073318655
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003687 Issued in MI
Practice address
26300 Telegraph Rd Ste 200
Southfield, MI 48033-5367
Phone
(810) 354-7714
NPI assigned
Feb 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003687 MI Primary

Addresses

Primary practice location

26300 Telegraph Rd Ste 200
Southfield, MI 48033-5367

Mailing address

4028 Parsons Walk
Saginaw, MI 48603-7259
Phone (989) 980-2776

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
I20250821001303 MI Practitioner - Physician Assistant 8820598279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Radiology Consultants P.C.Group PAC ID 7416485040, 52 clinicians

Practice addresses (Care Compare)

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (833) 364-7790

2583 S Shore Dr
Flushing, MI 48433-3515
Phone (833) 364-7790

529 Misty Morning Dr
Flushing, MI 48433-2195
Phone (833) 364-7790

826 W King St
Owosso, MI 48867-2120
Phone (833) 364-7790

900 Cooper Ave
Saginaw, MI 48602-5182
Phone (833) 364-7790

Hospital & facility affiliations

  • Memorial Healthcare Hospital, Owosso, MI, CCN 230121
  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601003687MIMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1073318655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 PARSONS WALK",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486037259",
            "telephone_number": "989-980-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26300 TELEGRAPH RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480335367",
            "telephone_number": "810-354-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSON",
        "first_name": "EDWARD",
        "middle_name": "COREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.