Individual provider Active NPI

Meghan Jacobs, P.A.

  • Physician Assistant
  • Caledonia, MI
National Provider Identifier
1952449027
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012381 Issued in MI
Practice address
9090 S Rodgers CT SE Ste a
Caledonia, MI 49316-8052
Phone
(616) 891-0422
NPI assigned
Feb 2, 2007
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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 5601012381 MI Primary

Addresses

Primary practice location

9090 S Rodgers CT SE Ste a
Caledonia, MI 49316-8052

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560

Other names 1

  • Meghan S Will Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mjacobs2557032@epic00.corewelldirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070705000104 MD Practitioner - Physician Assistant 2567562572 Reassigns benefits to 1 organization
I20240521001855 MI Practitioner - Physician Assistant 2567562572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
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

3185 Macatawa Dr SW a
Corewell Health Medical Group West
Grandville, MI 49418-3184
Phone (616) 391-4500

426 Michigan St NE
Corewell Health Medical Group West
Grand Rapids, MI 49503-5609
Phone (616) 267-8338

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

7751 Byron Ctr Ave SW a
Corewell Health Medical Group West
Byron Center, MI 49315-8001
Phone (616) 878-3321

7751 Byron Ctr Ave SW C
Corewell Health Medical Group West
Byron Center, MI 49315-8001
Phone (616) 267-7668

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601012381MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 8, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 8, 2024 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients
Joseph S. Fastow, M.D., P.a. Past Accepting new patients
Spectrum Health Primary Care Partners PastSince Jul 21, 2024 Accepting new patients

Locations

9090 S Rodgers Ct SE
Ste A
Caledonia, MI 49316
Phone (616) 891-0422

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

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

Interoperability endpoints

  • Direct secure messaging: mjacobs2557032@epic00.corewelldirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1952449027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9090 S RODGERS CT SE STE A",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168052",
            "telephone_number": "616-891-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MEGHAN",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjacobs2557032@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "9090 S Rodgers Ct SE Ste A",
            "city": "Caledonia",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493168052",
            "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": "9090 S Rodgers Ct SE Ste A",
            "city": "Caledonia",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493168052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEGHAN",
            "last_name": "WILL",
            "middle_name": "S",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Caledonia, MI

Sources for this page

Verify at the official NPI Registry.