NPIMap

Individual provider Active NPI

Jamie Lynn Qualls, DO, MPH

  • Family Medicine Physician
  • Flint, MI
National Provider Identifier
1619404746
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101024873 Issued in MI
Practice address
3709 E Court St
Flint, MI 48506-4148
Phone
(810) 743-1090
Fax
(810) 744-6526
NPI assigned
May 19, 2017
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 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 5101024873 MI Primary

Addresses

Primary practice location

3709 E Court St
Flint, MI 48506-4148

Mailing address

3709 E Court St
Flint, MI 48506-4148
Phone (810) 743-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809002115 MI Practitioner - Family Practice 7719305234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians
Genesys Pho LLCGroup PAC ID 7618240409, 10 clinicians

Practice addresses (Care Compare)

10785 S Saginaw St
Suite D
Grand Blanc, MI 48439-7003
Phone (810) 695-6337

1096 S Belsay Rd
Burton, MI 48509-1948

3495 S Ctr Rd
Burton, MI 48519-1455
Phone (810) 424-2201

6011 Porter Rd
Suite D
Grand Blanc, MI 48439-8538
Phone (810) 424-2401

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101024873MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Medical Group Genesys Family Medicine CurrentSince Aug 30, 2021 Accepting new patients
Henry Ford Medical Group Genesys CurrentSince Aug 30, 2021 Accepting new patients
Genesys Pho LLC CurrentSince Aug 30, 2021 Accepting new patients
Henry Ford Medical Group Genesys Family Medicine Current Accepting new patients
Genesys Integrated Group Practice PC Past Accepting new patients

Locations

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

3495 S Center Rd
Flint, MI 48519
Phone (810) 424-2025

3709 E Court St
Flint, MI 48506
Phone (810) 743-1090

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

Interoperability endpoints

  • Direct secure messaging: jamiequalls@pmi.allscriptsdirect.net
  • Direct secure messaging: jqualls359655@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1619404746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 E COURT ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485064148",
            "telephone_number": "810-743-1090",
            "fax_number": "810-744-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 E COURT ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485064148",
            "telephone_number": "810-743-1090",
            "fax_number": "810-744-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101024873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.