Individual provider Active NPI

Michelle C Garrison, PA-C

  • Physician Assistant
  • Newport, KY
National Provider Identifier
1578894713
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2621 Issued in KY
Practice address
1400 Grand Ave
Newport, KY 41071-2570
Phone
(856) 905-3070
Fax
(859) 441-1348
NPI assigned
Jan 28, 2010
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003015RX OH
Physician Assistant 363A00000X PA2621 KY Primary
Emergency Medicine Physician 207P00000X 50.003015RX OH

Addresses

Primary practice location

1400 Grand Ave
Newport, KY 41071-2570

Mailing address

600 Cross Pointe Rd
Suite a
Gahanna, OH 43230-6696
Phone (513) 725-2186

Other practice location 1

4355 Ferguson Dr
Suite 270
Cincinnati, OH 45245-5136
Phone (513) 718-0115

Other identifiers 1

IdentifierTypeStateIssuer
0088494MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, IN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20100211000127 OH Practitioner - Physician Assistant 7416090527 Reassigns benefits to 5 organizations
I20210618001247 KY Practitioner - Physician Assistant 7416090527 Reassigns benefits to 1 organization
I20220105001124 IN Practitioner - Physician Assistant 7416090527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, shared by 11 NPIs, 803 clinicians

Practice addresses (Care Compare)

1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 301-5901

1640 Flossie Dr
Greendale, IN 47025-8424
Phone (855) 277-4230

2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone (859) 301-5901

300 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 824-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.003015RXOHMDEmergency Medicine Physician
PA2621KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Accudoc Inc PC CurrentSince Feb 3, 2015 Accepting new patients
Summit Medical Group, Inc. Physician Assistant CurrentSince Dec 1, 2021 Accepting new patients
Accudoc Inc PC CurrentSince Feb 3, 2015 Accepting new patients
Summit Medical Group, Inc. Physician Assistant CurrentSince Jun 1, 2021 Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients
Laser Spine Institute, LLC Past Accepting new patients
Emergency Medicine Physicians of Hamilton County, LTD. Emergency Medicine Past Accepting new patients
Cincinnati Pain Management Consultants LTD Past Accepting new patients
Summit Medical Group, Inc Physician Assistant Past Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

334 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-3737

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

3300 Mercy Health Blvd
Cincinnati, OH 45211
Phone (513) 215-1114

620 Ring Rd
Harrison, OH 45030
Phone (513) 202-9600

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Interoperability endpoints

  • Direct secure messaging: mgarrison349130@direct-prd.stelizabeth.com

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 3

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": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1578894713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CROSS POINTE RD",
            "address_2": "SUITE A",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432306696",
            "telephone_number": "513-725-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 GRAND AVE",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712570",
            "telephone_number": "856-905-3070",
            "fax_number": "859-441-1348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4355 Ferguson Dr",
            "address_2": "Suite 270",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452455136",
            "country_code": "US",
            "telephone_number": "513-718-0115",
            "fax_number": "513-718-0116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-28",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003015RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2621",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "50.003015RX",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088494",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, KY

Sources for this page

Verify at the official NPI Registry.