Individual provider Active NPI

Jeffrey J Fox, PA-C

  • Physician Assistant
  • Grayling, MI
National Provider Identifier
1811915689
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002952 Issued in MI
Practice address
1250 E Michigan Ave
Grayling, MI 49738-7074
Phone
(989) 348-0550
NPI assigned
Jul 18, 2006
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 5601002952 MI Primary

Addresses

Primary practice location

1250 E Michigan Ave
Grayling, MI 49738-7074

Mailing address

1250 E Michigan Ave
C/O Payer Enrollment
Grayling, MI 49738-7074

Other practice location 1

234 Lake St
Roscommon, MI 48653-9203
Phone (989) 275-1200

Other practice location 2

2585 W Houghton Lake Dr
Prudenville, MI 48651-9624
Phone (989) 366-2900

Other practice location 3

1010 W North Down River Rd
Grayling, MI 49738-2060
Phone (989) 348-0880

Other practice location 4

1321 S Mount Tom Rd
Mio, MI 48647-9518
Phone (989) 275-1200

Other practice location 5

3860 S Straits Hwy
Indian River, MI 49749-5146
Phone (231) 238-0581

Other practice location 6

8881 M 119
Harbor Springs, MI 49740-9586
Phone (231) 347-5400

Other practice location 7

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

Other identifiers 1

IdentifierTypeStateIssuer
700F96001OtherMIBLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfox05@direct.mhc.net

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
I20040612000090 MI Practitioner - Physician Assistant 4082697784 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601002952MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Grayling CurrentSince Feb 1, 2015 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Dec 2, 2022 Accepting new patients
Munson Medical Group CurrentSince Oct 3, 2022 Accepting new patients
Munson Medical Center CurrentSince Dec 22, 2022 Accepting new patients
Munson Medical Group CurrentSince Oct 3, 2022 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Dec 2, 2022 Accepting new patients
Munson Healthcare Grayling CurrentSince Feb 1, 2015 Accepting new patients
Munson Medical Center CurrentSince Dec 22, 2022 Accepting new patients
Munson Healthcare Grayling Past Accepting new patients
Mercy Hospital Grayling Past Accepting new patients
Munson Healthcare Grayling Past Accepting new patients
Munson Medical Group Past Accepting new patients
Mercy Professional Services Past Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

1996 Walden Dr
Gaylord, MI 49735
Phone (517) 731-4111

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

1010 W North Down River Rd
Grayling, MI 49738
Phone (989) 348-0800

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

809 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0530

8881 M 119
Harbor Springs, MI 49740
Phone (231) 347-5400

1321 S Mount Tom Rd
Mio, MI 48647
Phone (989) 275-1200

2585 W Houghton Lake Dr
Prudenville, MI 48651
Phone (989) 348-0055

234 Lake St
Roscommon, MI 48653
Phone (517) 275-1200

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

1200 Sixth St
Ste 200
Traverse City, MI 49684

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

Interoperability endpoints

  • Direct secure messaging: jfox05@direct.mhc.net

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1811915689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E MICHIGAN AVE",
            "address_2": "C/O PAYER ENROLLMENT",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497387074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MICHIGAN AVE",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497387074",
            "telephone_number": "989-348-0550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Lake St",
            "address_purpose": "LOCATION",
            "city": "Roscommon",
            "state": "MI",
            "postal_code": "486539203",
            "country_code": "US",
            "telephone_number": "989-275-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2585 W Houghton Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Prudenville",
            "state": "MI",
            "postal_code": "486519624",
            "country_code": "US",
            "telephone_number": "989-366-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 W North Down River Rd",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497382060",
            "country_code": "US",
            "telephone_number": "989-348-0880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1321 S Mount Tom Rd",
            "address_purpose": "LOCATION",
            "city": "Mio",
            "state": "MI",
            "postal_code": "486479518",
            "country_code": "US",
            "telephone_number": "989-275-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3860 S Straits Hwy",
            "address_purpose": "LOCATION",
            "city": "Indian River",
            "state": "MI",
            "postal_code": "497495146",
            "country_code": "US",
            "telephone_number": "231-238-0581",
            "fax_number": "231-238-0856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8881 M 119",
            "address_purpose": "LOCATION",
            "city": "Harbor Springs",
            "state": "MI",
            "postal_code": "497409586",
            "country_code": "US",
            "telephone_number": "231-347-5400",
            "fax_number": "231-348-2515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "700F96001",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfox05@direct.mhc.net",
            "affiliation": "N",
            "address_1": "100 E Michigan Ave",
            "city": "Grayling",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497381741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grayling, MI

Sources for this page

Verify at the official NPI Registry.