Active NPI
Gina Wolf, PA-C
- Physician Assistant
- Three Rivers, MI
National Provider Identifier
1275050817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601008332
- Practice address
- 601 S US Highway 131
Three Rivers, MI 49093-8831 - Phone
- (269) 286-7070
- NPI assigned
- Aug 24, 2017
- Last updated
- Dec 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601008332 | MI | Primary |
Addresses
Primary practice location
601 S US Highway 131
Three Rivers, MI 49093-8831
Mailing address
601 John Street
Box 39
Kalamazoo, MI 49007
Other practice location 1
8088 Vineyard Drive
Kalamazoo, MI 49009
Phone (269) 286-7090
Other practice location 2
7901 Angling Rd
Portage, MI 49024-0714
Phone (269) 324-8600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601008332 | Other | MI | MICHIGAN PHYSICIAN ASSISTANT TEMPORARY LICENSE |
Other names 1
- Gina Stiver
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.bronsonhg.org | Direct | Bronson Healthcare Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8088 Vineyard Pkwy
Kalamazoo, MI 49009-3892
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Paw Paw, MI
- NPI 1962508259
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1831116441
-
dba Three Rivers Health
- General Acute Care Hospital
- Three Rivers, MI
- NPI 1568739423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1275050817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 JOHN STREET",
"address_2": "BOX 39",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 S US HIGHWAY 131",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490938831",
"telephone_number": "269-286-7070"
}
],
"practiceLocations": [
{
"address_1": "8088 Vineyard Drive",
"address_purpose": "LOCATION",
"city": "Kalamazoo",
"state": "MI",
"postal_code": "49009",
"country_code": "US",
"telephone_number": "269-286-7090",
"fax_number": "269-286-7091",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7901 Angling Rd",
"address_purpose": "LOCATION",
"city": "Portage",
"state": "MI",
"postal_code": "490240714",
"country_code": "US",
"telephone_number": "269-324-8600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLF",
"first_name": "GINA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-24",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601008332",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN PHYSICIAN ASSISTANT TEMPORARY LICENSE",
"identifier": "5601008332",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@direct.bronsonhg.org",
"affiliation": "Y",
"endpointDescription": "Bronson Healthcare Group Direct address",
"affiliationName": "Bronson Healthcare Group",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Continuity of Care Document",
"address_1": "601 John St",
"city": "Kalamazoo",
"state": "MI",
"country_code": "US",
"postal_code": "490075341",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "GINA",
"last_name": "STIVER",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Three Rivers, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.