Active NPI
Amy List, PA
- Physician Assistant
- Jackson, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601002245
- Practice address
- 309 Page Ave
Jackson, MI 49201-2419 - Phone
- (517) 787-1234
- Fax
- (517) 787-9140
- NPI assigned
- Mar 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5601002245 | MI | |
| Physician Assistant | 363A00000X | 5601002245 | MI | Primary |
Addresses
Primary practice location
309 Page Ave
Jackson, MI 49201-2419
Mailing address
24 Frank Lloyd Wright Dr Lbby J2000
Ann Arbor, MI 48105-9484
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700
51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304
5301 E Huron River Dr
Ypsilanti, MI 48197-1051
5301 McAuley Dr
Ypsilanti, MI 48197-1051
5325 Elliott Dr
Ypsilanti, MI 48197-8633
775 S Main St
Chelsea, MI 48118-1383
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Heart PC | Specialist | Current | Accepting new patients |
| Iha Health Service Corporation | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients |
Locations
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400
2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840
49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800
14650 E Old US Highway 12
Ste 204
Chelsea, MI 48118
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
309 Page Ave
Jackson, MI 49201
Phone (517) 205-1234
130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500
44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700
5325 Elliott Dr
Fl 2
Ypsilanti, MI 48197
Phone (734) 712-7242
5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020
5325 Elliott Dr
Ypsilanti, MI 48197
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 and National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Canton, MI
- NPI 1457408965
-
- Obstetrics & Gynecology Physician
- Ypsilanti, MI
- NPI 1831053701
-
- Neurological Surgery Physician
- Ypsilanti, MI
- NPI 1629726179
-
- Specialist
- Ypsilanti, MI
- NPI 1659321321
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brighton, MI
- NPI 1093748642
-
- General Acute Care Hospital
- Chelsea, MI
- NPI 1992761985
-
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1528035060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 PAGE AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012419",
"telephone_number": "517-787-1234",
"fax_number": "517-787-9140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIST",
"first_name": "AMY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-03",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "5601002245",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601002245",
"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 Jul 12, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.