Individual provider Active NPI

Jessica Elizabeth Lennard, PA-C

  • Physician Assistant
  • Commerce Township, MI
National Provider Identifier
1275296576
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010823 Issued in MI
Practice address
1 William Carls Dr
Commerce Township, MI 48382-2201
Phone
(248) 937-3740
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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 5601010823 MI Primary

Addresses

Primary practice location

1 William Carls Dr
Commerce Township, MI 48382-2201

Mailing address

1880 S Duck Lake Rd
Milford, MI 48381-1427
Phone (248) 895-4144

Other practice location 1

2420 Owen Rd Ste A
Fenton, MI 48430-3417
Phone (810) 496-2500

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
I20211108001220 MI Practitioner - Physician Assistant 2668861972 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group CurrentSince Aug 7, 2023 Accepting new patients
McLaren Medical Group Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

5701 Bow Pointe Dr
Ste 120
Clarkston, MI 48346
Phone (248) 625-2273

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

2420 Owen Rd
Ste A
Fenton, MI 48430
Phone (810) 496-2460

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

1375 N Main St
Lapeer, MI 48446
Phone (810) 667-5500

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 5

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": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1275296576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 S DUCK LAKE RD",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483811427",
            "telephone_number": "248-895-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822201",
            "telephone_number": "248-937-3740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2420 Owen Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MI",
            "postal_code": "484303417",
            "country_code": "US",
            "telephone_number": "810-496-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENNARD",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce Township, MI

Sources for this page

Verify at the official NPI Registry.