Active NPI
Jennifer McCalla, P.A.
- Physician Assistant
- Farmington Hills, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601004605
- Practice address
- 28050 Grand River Ave
Farmington Hills, MI 48336-5919 - Phone
- (248) 551-6689
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1070260 | MI | |
| Physician Assistant | 363A00000X | 5601004605 | MI | Primary |
Addresses
Primary practice location
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Other practice location 1
620 Byron Rd
Howell, MI 48843-1002
Phone (517) 545-6318
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmccalla2910433@epic00.corewelldirect.org |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1070260 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Providence Hospital | Current | Accepting new patients | |
| Henry Ford Health Providence Hospital | Physician Assistant | Current | Accepting new patients |
| Botsford General Hospital | Past | Accepting new patients |
Locations
47601 Grand River Ave
Ste B136
Novi, MI 48374
Phone (248) 465-3940
47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100
16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000
Interoperability endpoints
- jmccalla1140721@direct.hfhs.org
Organizations & group practices 4
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.
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- Southfield, MI
- NPI 1942265236
Physician Assistant
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- Royal Oak, MI
- NPI 1578072906
-
- Pediatrics Physician
- Southfield, MI
- NPI 1265497226
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1841233384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28050 GRAND RIVER AVE",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365919",
"telephone_number": "248-551-6689"
}
],
"practiceLocations": [
{
"address_1": "620 Byron Rd",
"address_purpose": "LOCATION",
"city": "Howell",
"state": "MI",
"postal_code": "488431002",
"country_code": "US",
"telephone_number": "517-545-6318",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCALLA",
"first_name": "JENNIFER",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-13",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "1070260",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601004605",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmccalla2910433@epic00.corewelldirect.org",
"affiliation": "N",
"address_1": "28050 Grand River Ave",
"city": "Farmington Hills",
"state": "MI",
"country_code": "US",
"postal_code": "483365919",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.