Individual provider Active NPI

Jessica Ruth Collister Priestley, MD, PHD

  • Clinical Biochemical Genetics Physician
  • Grand Rapids, MI
National Provider Identifier
1366935439
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Biochemical Genetics PhysicianTaxonomy code 207SG0202X
License
4301508672 Issued in MI
Practice address
25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526
Phone
(616) 391-2700
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Biochemical Genetics Physician 207SG0202X 4301508672 MI Primary

Addresses

Primary practice location

25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526

Mailing address

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

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918003977 MI Practitioner - Pediatric Medicine 0840654299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

100 Michigan St Northeast
Corewell Health Grand Rapids Hospit
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

25 Michigan St NE
Corewell Health Grand Rapids Hospit
Grand Rapids, MI 49503-2526
Phone (616) 391-3777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Hospitals CurrentSince Aug 28, 2023 Accepting new patients
Spectrum Health Hospitals CurrentSince Aug 28, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 13, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 13, 2023 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

25 Michigan St NE
Ste 2100
Grand Rapids, MI 49503
Phone (616) 391-3777

35 Michigan St NE
Ste 3003
Grand Rapids, MI 49503
Phone (616) 267-2200

25 Michigan St NE
Ste 2000
Grand Rapids, MI 49503
Phone (616) 391-2700

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: jpriestley1265345@epic00.corewelldirect.org

Organizations & group practices 4

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1366935439",
    "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": "25 MICHIGAN ST NE STE 2100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032526",
            "telephone_number": "616-391-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIESTLEY",
        "first_name": "JESSICA",
        "middle_name": "RUTH COLLISTER",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "MI",
            "license": "4301508672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.