Individual provider Active NPI

Jared Thomas Courtright, PA

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1265073027
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4100 Lake Dr SE Ste 205
Grand Rapids, MI 49546-8292
Phone
(616) 267-7100
NPI assigned
Oct 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 Primary

Addresses

Primary practice location

4100 Lake Dr SE Ste 205
Grand Rapids, MI 49546-8292

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Direct Messaging Address jcourtright251941@epic00.shdirect.org

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
I20191206000126 MI Practitioner - Physician Assistant 7719310663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

4100 Lake Dr SE
Grand Rapids, MI 49546-8292

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Physician Assistant CurrentSince Jan 20, 2020 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 20, 2020 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients

Locations

4100 Lake Dr SE
Ste 205
Grand Rapids, MI 49546
Phone (616) 267-7100

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: jcourtright251941@epic00.corewelldirect.org

Organizations & group practices 3

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": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1265073027",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE STE 205",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-267-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTRIGHT",
        "first_name": "JARED",
        "middle_name": "THOMAS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-03",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4100 Lake Dr SE Ste 205",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcourtright251941@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "4100 Lake Dr SE Ste 205",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.