Individual provider Active NPI

Jessica Lynn Bennett, PA-C

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1508757527
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5315261700 Issued in MI
Practice address
729 E Michigan Ave
Jackson, MI 49201-1625
Phone
(517) 539-3018
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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 5315261700 MI Primary

Addresses

Primary practice location

729 E Michigan Ave
Jackson, MI 49201-1625

Mailing address

507 N 17TH St
Milwaukee, WI 53233-2104

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
I20260327000361 MI Practitioner - Physician Assistant 2163907239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iep Urgent Care - Jackson PLLCGroup PAC ID 0042619132, 20 clinicians

Practice addresses (Care Compare)

729 E Michigan Ave
Jackson, MI 49201-1625
Phone (517) 539-3018

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5315261700MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iep Urgent Care - Jackson PLLC CurrentSince Nov 7, 2025 Accepting new patients

Locations

1602 W Michigan Ave
Jackson, MI 49202
Phone (517) 879-1166

729 E Michigan Ave
Jackson, MI 49201
Phone (517) 539-3018

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1508757527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N 17TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011625",
            "telephone_number": "517-539-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5315261700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.