Individual provider Active NPI

Jacob Lowell, PA-C

  • Physician Assistant
  • Spring Lake, MI
National Provider Identifier
1396610820
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013453 Issued in MI
Practice address
2 Summit Park Dr
Spring Lake, MI 49456-2079
Phone
(616) 283-9060
NPI assigned
Oct 6, 2025
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 5601013453 MI Primary

Addresses

Primary practice location

2 Summit Park Dr
Spring Lake, MI 49456-2079

Mailing address

2 Summit Park Dr
Spring Lake, MI 49456-2079
Phone (616) 283-9060

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
I20251129000415 MI Practitioner - Physician Assistant 4981197886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epi PCGroup PAC ID 0941293302, 16 clinicians

Practice addresses (Care Compare)

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 392-5141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601013453MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Epi PC CurrentSince Dec 15, 2025 Accepting new patients

Locations

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1396610820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SUMMIT PARK DR",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494562079",
            "telephone_number": "616-283-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SUMMIT PARK DR",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494562079",
            "telephone_number": "616-283-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWELL",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, MI

Sources for this page

Verify at the official NPI Registry.