Individual provider Active NPI

Wendy Michelle Davis, PAC

  • Physician Assistant
  • Marshall, MI
National Provider Identifier
1821188616
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003311 Issued in MI
Practice address
720 US Highway 27 N
Marshall, MI 49068-9609
Phone
(269) 781-6600
Fax
(269) 781-9228
NPI assigned
Oct 13, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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 5601003311 MI Primary

Addresses

Primary practice location

720 US Highway 27 N
Marshall, MI 49068-9609

Mailing address

720 US Highway 27 N
Marshall, MI 49068-9609
Phone (269) 781-6600

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
I20050114000682 MI Practitioner - Physician Assistant 7618926783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003311MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle Physician Assistant CurrentSince Jan 9, 2011 Accepting new patients
Ella E M Brown Charitable Circle Past Accepting new patients

Locations

1174 W Michigan Ave
Ste A
Marshall, MI 49068
Phone (269) 558-0700

1174 W Michigan Ave
Ste B
Marshall, MI 49068
Phone (269) 789-4390

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

720 US Highway 27 N
Marshall, MI 49068
Phone (269) 781-6600

Interoperability endpoints

  • Direct secure messaging: wendy.davis.1@9698.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821188616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 US HIGHWAY 27 N",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490689609",
            "telephone_number": "269-781-6600",
            "fax_number": "269-781-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 US HIGHWAY 27 N",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490689609",
            "telephone_number": "269-781-6600",
            "fax_number": "269-781-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WENDY",
        "middle_name": "MICHELLE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

Verify at the official NPI Registry.