Individual provider Active NPI

Jory Smith, PA-C

  • Physician Assistant
  • Traverse City, MI
National Provider Identifier
1730547399
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007652 Issued in MI
Practice address
5246 N Royal Dr
Traverse City, MI 49684-6984
Phone
(231) 935-0957
Fax
(231) 935-0960
NPI assigned
Feb 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007652 MI Primary

Addresses

Primary practice location

5246 N Royal Dr
Traverse City, MI 49684-6984

Mailing address

5246 N Royal Dr
Traverse City, MI 49684-6984
Phone (231) 935-0957

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160323002114 MI Practitioner - Physician Assistant 1456658152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Justin J Hollander PCGroup PAC ID 0244409928, 2 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

5246 N Royal Dr
Traverse City, MI 49684-6984
Phone (231) 935-0957

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007652MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Oct 25, 2019 Accepting new patients
Munson Medical Center CurrentSince Oct 25, 2019 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

1105 Sixth St
Ste 100
Traverse City, MI 49684
Phone (231) 392-0640

1221 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 392-0640

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1730547399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846984",
            "telephone_number": "231-935-0957",
            "fax_number": "231-935-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5246 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846984",
            "telephone_number": "231-935-0957",
            "fax_number": "231-935-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JORY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.