Active NPI
Jennifer B Dykhouse, PA
- Medical Physician Assistant
- Grand Rapids, MI
National Provider Identifier
1881769321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601004859
- Practice address
- 743 E Beltline Ave NE
Grand Rapids, MI 49525-6045 - Phone
- (616) 456-9553
- Fax
- (616) 454-5371
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601004859 | MI | Primary |
Addresses
Primary practice location
743 E Beltline Ave NE
Grand Rapids, MI 49525-6045
Mailing address
510 S Fair St
Otsego, MI 49078-1402
Other practice location 1
709 S Greenville West Dr
Greenville, MI 48838-3514
Phone (616) 754-9146
Other practice location 2
3210 Eagle Run Dr NE
Grand Rapids, MI 49525-7051
Phone (616) 456-9553
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601004859 | Other | MI | LICENSE |
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
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3210 Eagle Run Dr NE
Suite 100
Grand Rapids, MI 49525-7051
Phone (616) 456-9553
Hospital & facility affiliations
- Spectrum Health
- Spectrum Health United Hospital
- Corewell Health Big Rapids Hospital
- Corewell Health Reed City Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- jdykhouse75213@epic00.corewelldirect.org
Organizations & group practices 1
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.
-
- Specialist
- Grand Rapids, MI
- NPI 1780770859
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Big Rapids, MI
- NPI 1316945991
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- Critical Access Hospital
- Reed City, MI
- NPI 1437259843
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
-
- General Acute Care Hospital
- Greenville, MI
- NPI 1457304495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1881769321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 S FAIR ST",
"city": "OTSEGO",
"state": "MI",
"postal_code": "490781402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "743 E BELTLINE AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495256045",
"telephone_number": "616-456-9553",
"fax_number": "616-454-5371"
}
],
"practiceLocations": [
{
"address_1": "709 S Greenville West Dr",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "MI",
"postal_code": "488383514",
"country_code": "US",
"telephone_number": "616-754-9146",
"fax_number": "616-754-9152",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3210 Eagle Run Dr NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495257051",
"country_code": "US",
"telephone_number": "616-456-9553",
"fax_number": "616-454-5371",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DYKHOUSE",
"first_name": "JENNIFER",
"middle_name": "B",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601004859",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "5601004859",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.