Individual provider Active NPI

Jon Markham Vick, PA-C

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1790448124
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010691 Issued in MI
Practice address
5623 Gull Rd Ste 500
Kalamazoo, MI 49048-1098
Phone
(269) 775-8031
NPI assigned
Oct 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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 5601010691 MI Primary

Addresses

Primary practice location

5623 Gull Rd Ste 500
Kalamazoo, MI 49048-1098

Mailing address

601 John St # 42
Kalamazoo, MI 49007-5341

Other practice location 1

308 Charles St
Bangor, MI 49013-1317
Phone (260) 427-7937

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

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
I20211109002843 MI Practitioner - Physician Assistant 6002205218 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, shared by 3 NPIs, 721 clinicians

Practice addresses (Care Compare)

5623 Gull Rd
Kalamazoo, MI 49048-1098
Phone (269) 775-8031

6210 W Main St
Kalamazoo, MI 49009-8925
Phone (269) 286-7030

6220 W Main St
Kalamazoo, MI 49009-8925
Phone (269) 276-4744

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital Medical CurrentSince Apr 9, 2023 Accepting new patients
Bronson Battle Creek Hospital Physician Assistant CurrentSince Apr 9, 2023 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Apr 9, 2023 Accepting new patients
Bronson South Haven Hospital CurrentSince Apr 9, 2023 Accepting new patients
Bronson South Haven Hospital CurrentSince Apr 9, 2023 Accepting new patients
Bronson Lakeview Hospital CurrentSince Apr 9, 2023 Accepting new patients
Intercare Community Health Network CurrentSince Nov 1, 2021 Accepting new patients
Intercare Community Health Network CurrentSince Nov 1, 2021 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Apr 9, 2023 Accepting new patients

Locations

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

308 Charles St
Bangor, MI 49013
Phone (269) 427-7967

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

5623 Gull Rd
Ste 500
Kalamazoo, MI 49048
Phone (269) 775-8031

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 9

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": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1790448124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 GULL RD STE 500",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481098",
            "telephone_number": "269-775-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Charles St",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "MI",
            "postal_code": "490131317",
            "country_code": "US",
            "telephone_number": "260-427-7937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICK",
        "first_name": "JON",
        "middle_name": "MARKHAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-21",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.