Active NPI
Andrew M Marcin Jr., PA
- Physician Assistant
- Jackson, MI
National Provider Identifier
1477509727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601001198
- Practice address
- 1102 E Michigan Ave
Jackson, MI 49201-1802 - Phone
- (517) 780-7299
- NPI assigned
- May 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601001198 | MI | Primary |
Addresses
Primary practice location
1102 E Michigan Ave
Jackson, MI 49201-1802
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1477509727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 E MICHIGAN AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011802",
"telephone_number": "517-780-7299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCIN",
"first_name": "ANDREW",
"middle_name": "M",
"name_suffix": "Jr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601001198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.