Jonathan Michael Russell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007115 Issued in MI

Practice address

705 Oak St Unit 11
Big Rapids, MI 49307-3108

Phone

(231) 592-1002

NPI assigned

Aug 22, 2014

Last updated

Feb 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mecosta County Medical CenterGroup PAC ID 1951215540, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Big Rapids Hospital Hospital, Big Rapids, MI, CCN 230093
• Corewell Health Reed City Hospital Hospital, Reed City, MI, CCN 231323

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrussell110617@epic00.corewelldirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mecosta County Medical Center

  dba Spectrum Health Big Rapids Hospital

  • Cardiovascular Disease Physician
  • Big Rapids, MI
  • NPI 1386693471
  Medicare reassignment Care Compare group
• Reed City Hospital Corporation

  dba Corewell Health Reed City Hospital Professional

  • Family Medicine Physician
  • Reed City, MI
  • NPI 1831253798
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Mecosta County Medical Center

  dba Corewell Health Big Rapids Hospital

  • General Acute Care Hospital
  • Big Rapids, MI
  • NPI 1316945991
  NPD
• Reed City Hospital Corporation

  dba Spectrum Health Reed City Hospital Nurse Practitioners

  • General Practice Registered Nurse
  • Reed City, MI
  • NPI 1366735219
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West Urgent Care

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
  • NPI 1821422007
  NPD
• Mecosta County Medical Center

  dba Corewell Health Big Rapids Hospital Family Medicine - Canadian Lakes

  • Rural Health Clinic/Center
  • Canadian Lakes, MI
  • NPI 1477973493
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mecosta County Medical Center

  dba Corewell Health Big Rapids Hospital

  • General Acute Care Hospital
  • Big Rapids, MI
  • NPI 1316945991
  Care Compare affiliation
• Reed City Hospital Corporation

  dba Corewell Health Reed City Hospital

  • Critical Access Hospital
  • Reed City, MI
  • NPI 1437259843
  Care Compare affiliation

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1174922447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 OAK ST UNIT 11",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493073108",
            "telephone_number": "231-592-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrussell110617@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "705 Oak St Unit 11",
            "city": "Big Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493073108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "705 Oak St Unit 11",
            "city": "Big Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493073108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allison Royston
• Theresa Ann Ruelle, LMSW
• Thomas James Rundquist, M.A. L.P.C.
• Stephen Brian Rupp, MD
• Russell Rehabilitation Services LLC
• Mandy R Russell, O.D.
• Tracy Helen Sackett-Foster, P.A.C.
• Komal Saini
• Troy Edward Salinas, PA
• Samaritan Health Care, PC

• Physician Assistant in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.