NPIMap

Individual provider Active NPI

Emily Rosann Hedley, PA-C

  • Physician Assistant
  • Williamsburg, MI
National Provider Identifier
1942584875
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006107 Issued in MI
Practice address
3950 Shore Dr
Williamsburg, MI 49690-9548
Phone
(231) 938-7004
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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 5601006107 MI Primary

Addresses

Primary practice location

3950 Shore Dr
Williamsburg, MI 49690-9548

Mailing address

9758 E Valley Hills Dr
Traverse City, MI 49684-9553
Phone (231) 938-7004

Other practice location 1

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-0180

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
I20120103000084 MI Practitioner - Physician Assistant 0244406890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical Center 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

1121 6TH St
Suite 316
Traverse City, MI 49684-2345
Phone (231) 392-8280

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601006107MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Mar 12, 2022 Accepting new patients
Munson Medical Center CurrentSince Mar 12, 2022 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

5085 Anna Dr
Ste A
Traverse City, MI 49684
Phone (231) 935-0180

Organizations & group practices 14

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.

View all 14

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": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1942584875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9758 E VALLEY HILLS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849553",
            "telephone_number": "231-938-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 SHORE DR",
            "city": "WILLIAMSBURG",
            "state": "MI",
            "postal_code": "496909548",
            "telephone_number": "231-938-7004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-0180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDLEY",
        "first_name": "EMILY",
        "middle_name": "ROSANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, MI

Sources for this page

Verify at the official NPI Registry.