NPIMap

Individual provider Active NPI

Jennifer Kathleen Hall, PA-C

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1942561667
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006280 Issued in MI
Practice address
2009 Holton Rd
Muskegon, MI 49445-1578
Phone
(231) 291-8399
NPI assigned
May 30, 2012
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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 5601006280 MI Primary

Addresses

Primary practice location

2009 Holton Rd
Muskegon, MI 49445-1578

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Jennifer Kathleen King Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jking239097@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120628000449 MI Practitioner - Physician Assistant 9830354620 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

2009 Holton Rd
Muskegon, MI 49445-1578
Phone (231) 291-8399

204 W Main St
Corewell Health Gerber Hospital
Fremont, MI 49412-1181
Phone (231) 924-1800

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

922 Lawndale St
Ludington, MI 49431-1928
Phone (231) 845-7380

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Newaygo County General Hospital Association CurrentSince Sep 1, 2024 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 1, 2024 Accepting new patients
West Shore Cardiology, PLC Past Accepting new patients

Locations

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

2009 Holton Rd
North Muskegon, MI 49445
Phone (231) 291-8020

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1942561667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 HOLTON RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494451578",
            "telephone_number": "231-291-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JENNIFER",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jking239097@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2009 Holton Rd",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494451578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2009 Holton Rd",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494451578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KING",
            "middle_name": "KATHLEEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.