Jacob Taylor King

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

829 N Center Ave Ste 140
Gaylord, MI 49735-1598

Phone

(989) 731-7860

NPI assigned

Sep 16, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Healthcare Otsego Memorial HospitalGroup PAC ID 8325942535, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Munson Healthcare Otsego Memorial Hospital

  dba Munson Healthcare OMH Medical Group-Gaylord RHC

  • Rural Health Clinic/Center
  • Gaylord, MI
  • NPI 1164628426
  Medicare reassignment Care Compare group NPD
• Munson Healthcare Otsego Memorial Hospital

  dba MHC Great Lakes Plastic Surgery & Skin Center- Petoskey

  • Plastic Surgery Physician
  • Petoskey, MI
  • NPI 1770374530
  NPD
• Munson Healthcare Otsego Memorial Hospital

  dba Munson Healthcare OMH Medical Group-Gaylord

  • General Practice Physician
  • Gaylord, MI
  • NPI 1821064643
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1922835818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE STE 140",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351598",
            "telephone_number": "989-731-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE STE 140",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351598",
            "telephone_number": "989-731-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JACOB",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Keough, DO
• William Archibald Kerr, MD
• Katharine F Keys, RN
• Maria Khristov-Riveron
• Crystal Lynn King
• Caila Carolyn Kippe, PA-C
• Lauren Grace Kirby, LLMSW
• Jenni Kirt
• Justin Frank Klamerus, M.D.
• Aimee E Klein, RN

• Physician Assistant in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2026; 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.

Verify at the official NPI Registry.