Individual provider Active NPI

Jessica Lynne Fealy, MD

  • Pediatrics Physician
  • Ann Arbor, MI
National Provider Identifier
1083874713
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301092273 Issued in MI
Practice address
400 E Eisenhower Pkwy
Suite B
Ann Arbor, MI 48108-3302
Phone
(734) 232-2600
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301092273 MI Primary

Addresses

Primary practice location

400 E Eisenhower Pkwy
Suite B
Ann Arbor, MI 48108-3302

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111006000452 MI Practitioner - Pediatric Medicine 6002088481 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301092273MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Jun 30, 2011 Accepting new patients
Regents of the University of Michigan CurrentSince Jun 30, 2011 Accepting new patients
Regents of the University of Michigan Pediatrics Current Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

400 E Eisenhower Pkwy
Ste B
Ann Arbor, MI 48108
Phone (734) 232-2600

4260 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-5715

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

380 Parkland Plz
Ste 110
Ann Arbor, MI 48103
Phone (345) 395-0807

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

1051 N Canton Center Rd
Canton, MI 48187
Phone (734) 647-5670

3399 E Grand River Ave
Ste 202
Howell, MI 48843
Phone (517) 548-1020

39901 Traditions Dr
Ste 240
Northville, MI 48168
Phone (248) 305-4400

700 Woodland Dr
Saline, MI 48176
Phone (734) 429-2302

200 Arnet St
Ste 200
Ypsilanti, MI 48198
Phone (734) 482-6221

Interoperability endpoints

  • Direct secure messaging: jfealy26250@direct.med.umich.edu

Organizations & group practices 4

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1083874713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E EISENHOWER PKWY",
            "address_2": "SUITE B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083302",
            "telephone_number": "734-232-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEALY",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301092273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.