Jennifer Marie Anderson, PA-C
Individual provider Active NPI Physician Assistant · Zeeland, MI
NPI 1215129754 · NPPES record last updated Mar 18, 2016
Key facts
- NPI
- 1215129754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601003933 (MI)
- Practice address
- 8333 Felch St
Suite 200
Zeeland, MI 49464-1698 - Phone
- (616) 748-2850
- Fax
- (616) 748-2855
- NPI assigned
- Aug 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Holland Community Hospital
Practice addresses (Care Compare)
577 Michigan Ave
Holland, MI 49423-4911
8300 Westpark Way
Zeeland, MI 49464-7901
Hospital & facility affiliations
- Holland Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070921000754 | MI | Practitioner - Physician Assistant | 7012001969 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holland Community Hospital | Physician Assistant | Current |
Accepting new patients |
| Holland Community Hospital | Physician Assistant | Current |
Accepting new patients |
| Holland Community Hospital | Past | Accepting new patients | |
| Holland Community Hospital | Past | Accepting new patients |
Locations
415 Wiley Rd
Ste 102
Douglas, MI 49406
Phone (269) 857-3208
577 Michigan Ave
Ste 101
Holland, MI 49423
Phone (616) 393-2190
175 S Waverly Rd
Holland, MI 49423
Phone (616) 355-3896
3235 N Wellness Dr
Ste 120A
Holland, MI 49424
Phone (616) 395-2833
3235 N Wellness Dr
Bldg A
Holland, MI 49424
Phone (616) 395-2833
3235 N Wellness Dr
Holland, MI 49424
Phone (616) 399-9522
8300 Westpark Way
Zeeland, MI 49464
Phone (616) 748-5760
Interoperability endpoints
- jennifer.anderson@holland.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003933 | MI | Yes |
Addresses
Primary practice location
8333 Felch St
Suite 200
Zeeland, MI 49464-1698
Mailing address
3235 N Wellness Dr
Ste 120a
Holland, MI 49424-8035
Phone (616) 748-2850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08-5-70-1097-0 | Other | MI | BCBS |
| 5601003933 | Other | MI | LICENSE |
Other providers in Zeeland, MI
- A.C.E. Dentistry PLLC
- Paul Kenneth Aalderink
- Advanced Therapy Concepts, Inc
- Kendra Jean Anes
- Apollo Medical Group of West Michigan PLLC
- John E Arens
- Laura Jayne Arens
- Christina N Arnold
All providers in Zeeland, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.