Active NPI
Jennie Dare Chapman Payne, PA-C
- Physician Assistant
- Milford, MI
National Provider Identifier
1891762779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003830
- Practice address
- 560 N Milford Rd Ste 202
Milford, MI 48381-1532 - Phone
- (248) 892-2255
- NPI assigned
- Mar 1, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003830 | MI | Primary |
Addresses
Primary practice location
560 N Milford Rd Ste 202
Milford, MI 48381-1532
Mailing address
211 E Commerce Street
Milford, MI 48381-1532
Phone (248) 453-6643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2018 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003830 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1891762779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 E COMMERCE STREET",
"city": "MILFORD",
"state": "MI",
"postal_code": "483811532",
"telephone_number": "248-453-6643",
"fax_number": "888-746-5634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 N MILFORD RD STE 202",
"city": "MILFORD",
"state": "MI",
"postal_code": "483811532",
"telephone_number": "248-892-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "JENNIE DARE",
"middle_name": "CHAPMAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-01",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.