Individual provider Active NPI

Jacqueline Michaela Davis, PA-C

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1740008069
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
505 N Jackson St
Jackson, MI 49201-1266
Phone
(517) 748-5500
NPI assigned
Sep 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 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 Primary

Addresses

Primary practice location

505 N Jackson St
Jackson, MI 49201-1266

Mailing address

505 N Jackson St
Jackson, MI 49201-1266
Phone (517) 748-5500

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
I20241119004641 MI Practitioner - Physician Assistant 5890220412 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family HealthGroup PAC ID 4587574421, 39 clinicians

Practice addresses (Care Compare)

505 N Jackson St
Jackson, MI 49201-1266

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Health Physician Assistant CurrentSince Jun 2, 2025 Accepting new patients
Center for Family Health CurrentSince Jun 2, 2025 Accepting new patients
Center for Family Health Physician Assistant Past Accepting new patients

Locations

544 Wildwood Ave
Jackson, MI 49201
Phone (517) 780-0838

505 N Jackson St
Jackson, MI 49201
Phone (517) 748-5500

6700 Rives Junction Rd
Jackson, MI 49201
Phone (517) 569-3200

1024 Fleming Ave
Jackson, MI 49202
Phone (517) 748-5500

1200 N West Ave
Jackson, MI 49202
Phone (517) 789-1200

2400 4th St
Jackson, MI 49203
Phone (517) 788-6812

Interoperability endpoints

  • Direct secure messaging: jdavis1088014@direct.hfhs.org

Organizations & group practices 11

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 2

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": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1740008069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JACQUELINE",
        "middle_name": "MICHAELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.