Individual provider Active NPI

Rebecca Marie Knauf, PA-C

  • Physician Assistant
  • Sparta, MI
National Provider Identifier
1376017525
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008979 Issued in MI
Practice address
2111 12 Mile Rd NW
Sparta, MI 49345-9754
Phone
(616) 391-8470
NPI assigned
Jan 21, 2019
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 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 5601008979 MI Primary

Addresses

Primary practice location

2111 12 Mile Rd NW
Sparta, MI 49345-9754

Mailing address

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

Other names 1

  • Rebecca Harrison Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rknauf244591@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

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
I20190204002732 MI Practitioner - Physician Assistant 8729325410 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2750 E Beltline Ave NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-8614
Phone (616) 267-8950

2750 E Beltline Ave NE FL
Grand Rapids, MI 49525-8614

2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone (616) 267-8860

4069 Lake Dr SE
Grand Rapids, MI 49546-8816

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

8501 Meadow CRK
Rockford, MI 49341-7524
Phone (616) 267-8950

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group Physician Assistant CurrentSince Jan 29, 2019 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Mecosta County Medical Center CurrentSince Oct 15, 2022 Accepting new patients
Mecosta County Medical Center Physician Assistant CurrentSince Oct 15, 2022 Accepting new patients
Reed City Hospital Corporation CurrentSince Oct 15, 2022 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Jan 29, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Apr 15, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Apr 15, 2019 Accepting new patients
Reed City Hospital Corporation CurrentSince Oct 15, 2022 Accepting new patients

Locations

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

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

2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015

2750 E Beltline Ave NE
Fl 1
Grand Rapids, MI 49525
Phone (616) 391-6271

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

300 N Patterson Rd
Reed City, MI 49677
Phone (231) 832-3271

2111 12 Mile Rd NW
Sparta, MI 49345
Phone (616) 391-8470

Interoperability endpoints

  • Direct secure messaging: rknauf244591@epic00.corewelldirect.org
  • Direct secure messaging: rknauf244591@epic00.shdirect.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1376017525",
    "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": "2111 12 MILE RD NW",
            "city": "SPARTA",
            "state": "MI",
            "postal_code": "493459754",
            "telephone_number": "616-391-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAUF",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rknauf244591@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2750 E Beltline Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495258614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2111 12 Mile Rd NW",
            "city": "Sparta",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493459754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "HARRISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sparta, MI

Sources for this page

Verify at the official NPI Registry.