Individual provider Active NPI

Jennifer Lynn Dear, M.D.

  • Family Medicine Physician
  • Norton Shores, MI
National Provider Identifier
1609864164
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01056316A Issued in IN
Practice address
5000 Hakes Dr
Norton Shores, MI 49441-5574
Phone
(231) 798-4445
Fax
(231) 798-4462
NPI assigned
Oct 10, 2005
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01056316A IN Primary

Addresses

Primary practice location

5000 Hakes Dr
Norton Shores, MI 49441-5574

Mailing address

5000 Hakes Dr
Norton Shores, MI 49441-5574
Phone (231) 798-4445

Other practice location 1

40 W Saginaw Rd
Sanford, MI 48657-9206
Phone (855) 507-3299

Other identifiers 4

IdentifierTypeStateIssuer
00000063937OtherINBCBS
000000685042OtherINBCBS
4301099906OtherMIMI LICENSE
200386980MedicaidIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120203000262 MI Practitioner - Family Practice 0749293595 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01056316AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient One Care PLLC CurrentSince Dec 15, 2021 Accepting new patients
American Current Care of Michigan PC CurrentSince Jan 2, 2023 Accepting new patients
Promed Healthcare CurrentSince Jul 1, 2020 Accepting new patients
Beacon Medical Group Michigan Inc Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
American Current Care of Michigan PC CurrentSince Jan 2, 2023 Accepting new patients
Patient One Care, PLLC CurrentSince Dec 15, 2021 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Medicine Past Accepting new patients

Locations

1740 28th St SE
Grand Rapids, MI 49508
Phone (616) 200-8669

436 44th St SE
Ste A
Kentwood, MI 49548
Phone (616) 531-9750

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

11569 E 12 Mile Rd
Warren, MI 48093
Phone (586) 582-0018

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1609864164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HAKES DR",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494415574",
            "telephone_number": "231-798-4445",
            "fax_number": "231-798-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HAKES DR",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494415574",
            "telephone_number": "231-798-4445",
            "fax_number": "231-798-4462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 W Saginaw Rd",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "MI",
            "postal_code": "486579206",
            "country_code": "US",
            "telephone_number": "855-507-3299",
            "fax_number": "989-837-9473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAR",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01056316A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00000063937",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000685042",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4301099906",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200386980",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.