Individual provider Active NPI

Jennifer Lynn Flanery, PA-C

  • Medical Physician Assistant
  • Shelby, MI
National Provider Identifier
1407033491
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601005195 Issued in MI
Practice address
71 Bevier St
Shelby, MI 49455
Phone
(231) 861-2187
Fax
(231) 861-5100
NPI assigned
Jan 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601005195 MI Primary

Addresses

Primary practice location

71 Bevier St
Shelby, MI 49455

Mailing address

PO Box 1848
Muskegon, MI 49443-1848
Phone (231) 727-5211

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
I20090127000492 MI Practitioner - Physician Assistant 3577627116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health PartnersGroup PAC ID 1456430016, 65 clinicians

Practice addresses (Care Compare)

5656 W US Hwy 10
Ludington, MI 49431-2454
Phone (231) 316-1014

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601005195MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners CurrentSince Mar 1, 2014 Accepting new patients
Mercy Health Partners CurrentSince Mar 1, 2014 Accepting new patients
Mercy Health Partners Past Accepting new patients

Locations

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

905 E Colby St
Whitehall, MI 49461
Phone (231) 672-8050

Organizations & group practices 3

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 3

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": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1407033491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431848",
            "telephone_number": "231-727-5211",
            "fax_number": "231-727-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 BEVIER ST",
            "city": "SHELBY",
            "state": "MI",
            "postal_code": "49455",
            "telephone_number": "231-861-2187",
            "fax_number": "231-861-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANERY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, MI

Sources for this page

Verify at the official NPI Registry.