Individual provider Active NPI

Jamie Lynn Dickinson, PA

  • Physician Assistant
  • Grand Haven, MI
National Provider Identifier
1457567158
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004993 Issued in MI
Practice address
15100 Whittaker Way
Grand Haven, MI 49417-8696
Phone
(616) 935-6320
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 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 5601004993 MI Primary

Addresses

Primary practice location

15100 Whittaker Way
Grand Haven, MI 49417-8696

Mailing address

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

Other names 1

  • Jamie Lynn Schraft Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jdickinson831659@direct.trinity-health.org Direct
Direct Messaging Address jdickinson187120@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
I20070917000330 MI Practitioner - Physician Assistant 5698869030 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004993MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackley Community Care Center, Inc CurrentSince May 1, 2007 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 15, 2024 Accepting new patients
Hackley Community Care Center Inc CurrentSince May 1, 2007 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 15, 2024 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients

Locations

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

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

2700 Baker St
Fl 3
Muskegon Heights, MI 49444
Phone (231) 733-6607

Interoperability endpoints

  • Direct secure messaging: jdickinson187120@epic00.shdirect.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1457567158",
    "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": "15100 WHITTAKER WAY",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494178696",
            "telephone_number": "616-935-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdickinson831659@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Health Physician Partners",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "601 W Savidge St",
            "city": "Spring Lake",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494561620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdickinson187120@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "15100 Whittaker Way",
            "city": "Grand Haven",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494178696",
            "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": "15100 Whittaker Way",
            "city": "Grand Haven",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494178696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "SCHRAFT",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.