Katie Rose Jennings, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011951 Issued in MI

Practice address

3000 Old Centre Rd
Portage, MI 49024-4883

Phone

(269) 321-7546

Fax

(269) 321-1705

NPI assigned

Sep 6, 2023

Last updated

Jun 3, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Three Rivers Health System IncGroup PAC ID 8729245584, 42 clinicians

Lakeland Community Hospital WatervlietGroup PAC ID 7416942750, 66 clinicians

Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078
• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment Care Compare group NPD
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital Primary Care - Hartford

  • Rural Health Clinic/Center
  • Hartford, MI
  • NPI 1023114741
  Medicare reassignment Care Compare group
• Three Rivers Health System, Inc

  dba Three Rivers Health Family Care White Pigeon

  • Rural Health Clinic/Center
  • White Pigeon, MI
  • NPI 1720350903
  Medicare reassignment Care Compare group
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • Rural Health Clinic/Center
  • Dowagiac, MI
  • NPI 1184467607
  NPD
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospitals

  • Family Medicine Physician
  • Watervliet, MI
  • NPI 1568644052
  NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD
• Three Rivers Health System, Inc

  dba Three Rivers Health Infectious Disease

  • Infectious Disease Physician
  • Three Rivers, MI
  • NPI 1346874070
  NPD
• Three Rivers Health System, Inc

  dba Three Rivers Health Center for Family Medicine

  • Rural Health Clinic/Center
  • Three Rivers, MI
  • NPI 1790144079
  NPD
• Three Rivers Health

  dba Three Rivers Health Internal Medicine

  • Internal Medicine Physician
  • Three Rivers, MI
  • NPI 1346224367
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • General Acute Care Hospital
  • Watervliet, MI
  • NPI 1700994845
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  dba Corewell Health Lakeland Hospitals

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1609652510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7760 TS AVE E",
            "city": "SCOTTS",
            "state": "MI",
            "postal_code": "490889748",
            "telephone_number": "248-762-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 OLD CENTRE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244883",
            "telephone_number": "269-321-7546",
            "fax_number": "269-321-1705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "551 Linn St",
            "address_purpose": "LOCATION",
            "city": "Allegan",
            "state": "MI",
            "postal_code": "490101595",
            "country_code": "US",
            "telephone_number": "269-321-7546",
            "fax_number": "269-321-1705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 S Health Pkwy",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490939387",
            "country_code": "US",
            "telephone_number": "269-321-7546",
            "fax_number": "269-321-1705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Watervliet",
            "state": "MI",
            "postal_code": "490989225",
            "country_code": "US",
            "telephone_number": "269-463-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3950 Hollywood Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490859151",
            "country_code": "US",
            "telephone_number": "269-408-1625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "451 Health Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Paw Paw",
            "state": "MI",
            "postal_code": "490798242",
            "country_code": "US",
            "telephone_number": "269-321-7546",
            "fax_number": "269-321-1705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "KATIE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011951",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601011951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Portage, MI
• Providers in Portage, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.

Verify at the official NPI Registry.