NPIMap

Individual provider Active NPI

Alexis Atwell, PA-C

  • Physician Assistant
  • Fairview, MI
National Provider Identifier
1417646571
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1910 E Miller Rd
Fairview, MI 48621-8731
Phone
(989) 848-5644
Fax
(989) 318-4606
NPI assigned
May 4, 2023
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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 Primary

Addresses

Primary practice location

1910 E Miller Rd
Fairview, MI 48621-8731

Mailing address

1910 E Miller Rd
Fairview, MI 48621-8731
Phone (989) 848-5644

Other practice location 1

11899 M 32
Atlanta, MI 49709-9374
Phone (989) 785-4855

Other names 1

  • Alexis Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240530001649 MI Practitioner - Physician Assistant 3173965514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11899 M
Suite 32
Atlanta, MI 49709-9374
Phone (989) 785-4855

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thunder Bay Community Health Service, Inc CurrentSince Apr 24, 2024 Accepting new patients
Thunder Bay Community Health Service, Inc CurrentSince Apr 24, 2024 Accepting new patients
Thunder Bay Community Health Service, Inc Past Accepting new patients

Locations

11899 M 32
Atlanta, MI 49709
Phone (866) 808-7540

1910 E Miller Rd
Fairview, MI 48621
Phone (989) 848-5484

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1417646571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 E MILLER RD",
            "city": "FAIRVIEW",
            "state": "MI",
            "postal_code": "486218731",
            "telephone_number": "989-848-5644",
            "fax_number": "989-318-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 E MILLER RD",
            "city": "FAIRVIEW",
            "state": "MI",
            "postal_code": "486218731",
            "telephone_number": "989-848-5644",
            "fax_number": "989-318-4606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11899 M 32",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "MI",
            "postal_code": "497099374",
            "country_code": "US",
            "telephone_number": "989-785-4855",
            "fax_number": "989-318-4606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATWELL",
        "first_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "SMITH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairview, MI

Sources for this page

Verify at the official NPI Registry.