Lisa Kaye Bowersox, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004147 Issued in MI

Practice address

311 W Mitchell St
Petoskey, MI 49770-2327

Phone

(616) 326-0114

Fax

(231) 487-6172

NPI assigned

Nov 14, 2006

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Female

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derm Institute of West Michigan PLCGroup PAC ID 5092044487, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Derm Institute of West Michigan PLC

  dba Derm Institute

  • Dermatology Physician
  • Caledonia, MI
  • NPI 1003460874
  Medicare reassignment Care Compare group
• Emergency Medical Associates, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1346227626

  Physician Assistant

  NPD (past)

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

• McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
  • NPI 1336897735
  Care Compare affiliation
• McLaren Northern Michigan

  • General Acute Care Hospital
  • Petoskey, MI
  • NPI 1992812580
  Care Compare affiliation

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1942372255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W MITCHELL ST",
            "address_2": "STE 1",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702357",
            "telephone_number": "231-348-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W MITCHELL ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702327",
            "telephone_number": "616-326-0114",
            "fax_number": "231-487-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERSOX",
        "first_name": "LISA",
        "middle_name": "KAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Anne Bonnington, RPH
• Katie Elizabeth Boonie, PHARMACY TECHNICIAN
• Lawrence Paul Borrusch, RPH
• Laura Anne Bottomley-Brown, FNP-C
• Margaret Emily-Pawlowski Bovee, FNP-C
• Jennifer A Brabant
• Akira Bradshaw
• Mark Braendle
• Linda Brant, RN
• Margaret M. Brazones, D.D.S., M.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.

Verify at the official NPI Registry.