Maddison Jane Liggett, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2200 Dendvinos Drive
Suite 102
Traverse City, MI 49684

Phone

(616) 331-5700

Fax

(616) 331-5999

NPI assigned

Nov 14, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maddison Medler Former name

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Traverse Physician Services PCGroup PAC ID 2466963806, 119 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Grand Traverse Physician Services PC

  • Hospitalist Physician
  • Traverse City, MI
  • NPI 1932913217
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1669296703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAMPUS DRIVE",
            "address_2": "2015 JAMES H. ZUMBERGE HALL",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019403",
            "telephone_number": "616-331-5700",
            "fax_number": "616-331-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 DENDVINOS DRIVE",
            "address_2": "SUITE 102",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "616-331-5700",
            "fax_number": "616-331-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGGETT",
        "first_name": "MADDISON",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADDISON",
            "last_name": "MEDLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tasheenia L Lewis
• Karen A. Lewit, OTR,CHT
• Kayleigh Lewthwaite
• Alyssa Ann Lichon
• Norman J Licht, M.D.
• Rachel Light
• Lighthouse Chiropractic & Wellness Center, PLC
• Cyrilla Dawn Lillie, PHARMACY TECHNICIAN
• Lincare Inc.
• Christina Lindall

• Physician Assistant in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.