Individual provider Active NPI

Allison B Klumpp, PA-C

  • Physician Assistant
  • Roscommon, MI
National Provider Identifier
1881160299
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008791 Issued in MI
Practice address
135 Lake St
Roscommon, MI 48653-7697
Phone
(989) 422-5122
Fax
(989) 422-4378
NPI assigned
Oct 23, 2018
Last updated
Nov 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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 5601008791 MI Primary

Addresses

Primary practice location

135 Lake St
Roscommon, MI 48653-7697

Mailing address

9249 W Lake City Rd
Houghton Lake, MI 48629-9602
Phone (989) 422-5122

Other practice location 1

9249 W Lake City Rd
Houghton Lake, MI 48629-9602
Phone (989) 422-5122

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
I20181204002515 MI Practitioner - Physician Assistant 8628312543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811

5115 E Pickard St
McLaren Heart Center
Mt Pleasant, MI 48858-5006
Phone (989) 956-4100

740 S Main St
Cheboygan, MI 49721-2220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601008791MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan CurrentSince Apr 11, 2022 Accepting new patients
McLaren Central Michigan CurrentSince Apr 11, 2022 Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

5115 E Pickard St
Ste A
Mt Pleasant, MI 48858

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1881160299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9249 W LAKE CITY RD",
            "city": "HOUGHTON LAKE",
            "state": "MI",
            "postal_code": "486299602",
            "telephone_number": "989-422-5122",
            "fax_number": "989-422-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 LAKE ST",
            "city": "ROSCOMMON",
            "state": "MI",
            "postal_code": "486537697",
            "telephone_number": "989-422-5122",
            "fax_number": "989-422-4378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9249 W Lake City Rd",
            "address_purpose": "LOCATION",
            "city": "Houghton Lake",
            "state": "MI",
            "postal_code": "486299602",
            "country_code": "US",
            "telephone_number": "989-422-5122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLUMPP",
        "first_name": "ALLISON",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roscommon, MI

Sources for this page

Verify at the official NPI Registry.