Michelle L Jennings, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07522 Issued in TX

Practice address

1400 Bryan Dr
Suite 303
Durant, OK 74701-2156

Phone

(580) 931-2227

Fax

(580) 931-2057

NPI assigned

Jan 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Michelle L Jennings Other name

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.van.fossen.1@9148.direct.athenahealth.com

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.

• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  OK

  Medicare reassignment NPD
• Hunt Regional Medical Partners

  • Family Medicine Physician
  • Greenville, TX
  • NPI 1235435892
  Medicare reassignment NPD
• Hunt Regional Medical Partners

  • Rural Health Clinic/Center
  • Greenville, TX
  • NPI 1548143134
  NPD
• Paris-Lamar County Health District

  • Public Health or Welfare Agency
  • Paris, TX
  • NPI 1164778700
  NPD (past)

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1487925715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 71 BOX 157-1",
            "city": "SOPER",
            "state": "OK",
            "postal_code": "747599764",
            "telephone_number": "210-885-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BRYAN DR",
            "address_2": "SUITE 303",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012156",
            "telephone_number": "580-931-2227",
            "fax_number": "580-931-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2281",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2281",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JENNINGS",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Deepak S. Jaiswal, M.D.
• Latoya Savon James, MHR, LADC-MH, LPC-S
• Janee Standifer SLP, LLC
• Olen Lynn Jestis II, D.O.
• Amanda Beth Johnson
• Bryan L Johnson, O.D.
• David Johnson
• Kelly Gaines Johnson, AU.D.

• Physician Assistant in Durant, OK
• Providers in Durant, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.