Jessica Pearl Bennett-Soave

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101020969 Issued in MI

Practice address

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Phone

(586) 263-2950

Fax

(586) 263-2975

NPI assigned

Apr 14, 2014

Last updated

Sep 6, 2024By 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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11357/brand/3/csg/1/fhir/r4
• Direct secure messaging: jbennet273162@direct.hfhs.org
• Direct secure messaging: jbennett73221@direct.covenanthealthcare.com

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.

• Deckerville Community Hospital, Inc.

  • Family Medicine Physician
  • Deckerville, MI
  • NPI 1164540555

  Emergency Medicine

  Medicare reassignment NPD
• Hills & Dales General Hospital, Inc.

  • Critical Access Hospital
  • Cass City, MI
  • NPI 1154367001
  Medicare reassignment NPD
• Hillsdale Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Hillsdale, MI
  • NPI 1669018206
  Medicare reassignment NPD
• Huron Emergency Medicine Specialists, PLLC

  • Emergency Medicine Physician
  • Port Huron, MI
  • NPI 1528686540
  Medicare reassignment NPD
• Marlette Regional Hospital

  • Emergency Medicine Physician
  • Marlette, MI
  • NPI 1598840498
  Medicare reassignment NPD
• Memorial Hospital

  dba Memorial Medical Associates

  • General Practice Physician
  • Owosso, MI
  • NPI 1235160532

  Emergency Medicine

  Medicare reassignment NPD
• Deckerville Community Hospital Inc

  • Critical Access Hospital
  • Deckerville, MI
  • NPI 1619095718
  Medicare reassignment
• Marlette Regional Hospital

  • Critical Access Hospital
  • Marlette, MI
  • NPI 1346325214
  Medicare reassignment
• Deckerville Community Hospital, Inc

  dba Port Sanilac Healthcare

  • Clinic/Center
  • Port Sanilac, MI
  • NPI 1013799469
  NPD
• Deckerville Community Hospital, Inc.

  • Family Medicine Physician
  • Deckerville, MI
  • NPI 1164818977
  NPD
• Marlette Regional Hospital

  dba Aspire Angle Street Clinic

  • Family Medicine Physician
  • Marlette, MI
  • NPI 1730988999
  NPD
• Memorial Hospital

  dba Memorial Medical Associates

  • Anesthesiology Physician
  • Owosso, MI
  • NPI 1659527737
  NPD

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1720407265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2950",
            "fax_number": "586-263-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2950",
            "fax_number": "586-263-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT-SOAVE",
        "first_name": "JESSICA",
        "middle_name": "PEARL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101020969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbennett73221@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "4675 Hill St",
            "city": "Cass City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487261099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benedetta S Hair Salon & Spa Co Inc.
• Alexandra Benejam
• Benevolent Hearts Services, LLC
• Brian Bengtson
• Joanna Edna Benjamin, M.A. CF-SLP
• Paul Alason Berger III, D.O.
• Megan Mary Bergeron
• Mark D Berman, D.D.S.
• Kimberly Marie Bernock
• Staci Fields Bernstein, LLP

• Emergency Medicine Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.