Jasper Gill, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

5101021302 Issued in MI

Practice address

4986 N Adams Rd Ste a
Rochester, MI 48306

Phone

(248) 475-4301

NPI assigned

Apr 15, 2014

Last updated

Feb 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, TX, FL, VA, MD, DC, CT, NV, TN9 enrollments

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 9

Specialty

Sports Medicine

Education

Michigan State University College of Osteopathic Medicine, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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.

• Img Medical Group de PA

  • Sports Medicine (Family Medicine) Physician
  • Boynton Beach, FL
  • NPI 1720708589

  DC, MD, NV, TN, VA

  Medicare reassignment
• Img Medical Group TX, P.a.

  • Sports Medicine (Family Medicine) Physician
  • Dallas, TX
  • NPI 1619659760
  Medicare reassignment
• Country Creek Family Medicine PLLC

  • Family Medicine Physician
  • Rochester, MI
  • NPI 1790537041

  Multi-Specialty

  NPD
• Partners in Wellness

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1518461524
  NPD (past)
• Conviva Medical Center Management LLC

  dba Conviva Care Center

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1700205846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4986 N ADAMS RD STE A",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483065017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4986 N ADAMS RD STE A",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "48306",
            "telephone_number": "248-475-4301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3031 W Grand Blvd",
            "address_2": "Suite 450",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482023046",
            "country_code": "US",
            "telephone_number": "313-346-5235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "244 N Congress Ave",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334264212",
            "country_code": "US",
            "telephone_number": "781-254-8837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "JASPER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101021302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas George
• David Gregory Gerst III, M.D.
• Maha M Ghalib, MD
• Amanda Renee Gibson, MA, LLPC
• Kathleen Gildner
• Kara Gittins, R.D.
• Melissa Ann Glavich
• Margaret Glembocki, NURSE PRACTITIONER
• Shannon Marie Glodich, LPC
• Dale Anthony Gonzales, MD

• Sports Medicine (Family Medicine) Physician in Rochester, MI
• Providers in Rochester, MI by specialty
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.