Individual provider Active NPI

Jennifer Rose, PA

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1891248332
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
400 Hinckley Blvd Ste 100
Jackson, MI 49203-6152
Phone
(517) 205-8991
Fax
(517) 205-0114
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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 MI Primary

Addresses

Primary practice location

400 Hinckley Blvd Ste 100
Jackson, MI 49203-6152

Mailing address

400 Hinckley Blvd Ste 100
Jackson, MI 49203-6152
Phone (517) 205-8991

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
I20161011000295 MI Practitioner - Physician Assistant 5395033146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

3305 Spring Arbor Rd
Suite 200
Jackson, MI 49203-3995
Phone (517) 205-3187

400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6152
Phone (517) 205-8991

7845 Spring Arbor Rd
Spring Arbor, MI 49283-9785
Phone (517) 205-2580

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Oct 1, 2016 Accepting new patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Oct 1, 2016 Accepting new patients
Wa Foote Memorial Hospital, Inc Physician Assistant Past Accepting new patients

Locations

1401 W North St
Jackson, MI 49202
Phone (517) 205-2555

400 Hinckley Blvd
Ste 100
Jackson, MI 49203
Phone (517) 205-8991

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1891248332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HINCKLEY BLVD STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492036152",
            "telephone_number": "517-205-8991",
            "fax_number": "517-205-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HINCKLEY BLVD STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492036152",
            "telephone_number": "517-205-8991",
            "fax_number": "517-205-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.