Individual provider Active NPI

Michelle R Jans, PA-C

  • Physician Assistant
  • Nevada, IA
National Provider Identifier
1972557809
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01206 Issued in IA
Practice address
640 S 19TH St
Nevada, IA 50201-2902
Phone
(515) 382-2111
Fax
(515) 382-7760
NPI assigned
May 22, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 01206 IA Primary

Addresses

Primary practice location

640 S 19TH St
Nevada, IA 50201-2902

Mailing address

640 S 19TH St
Nevada, IA 50201-2902
Phone (515) 382-2111

Other practice location 1

731 Main St
Jewell, IA 50130-2040
Phone (515) 827-6175

Other identifiers 1

IdentifierTypeStateIssuer
35739OtherIABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20071210000565 IA Practitioner - Physician Assistant 8921104662 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001206IAMDSpecialist
01206IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Story County Hospital CurrentSince Jan 1, 2011 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Story County Hospital CurrentSince Jan 1, 2011 Accepting new patients
The Iowa Clinic PC PastSince Oct 1, 1995 Accepting new patients
Hamilton County Public Hospital Physician Assistant Past Accepting new patients
The Iowa Clinic, PC Past Accepting new patients

Locations

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

640 S 19th St
Nevada, IA 50201
Phone (515) 382-2111

640 S 19th St
Ste 100
Nevada, IA 50201
Phone (515) 382-5413

Interoperability endpoints

  • Direct secure messaging: mjans431338@direct.unitypoint.org

Organizations & group practices 6

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972557809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S 19TH ST",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502012902",
            "telephone_number": "515-382-2111",
            "fax_number": "515-382-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S 19TH ST",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502012902",
            "telephone_number": "515-382-2111",
            "fax_number": "515-382-7760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Main St",
            "address_purpose": "LOCATION",
            "city": "Jewell",
            "state": "IA",
            "postal_code": "501302040",
            "country_code": "US",
            "telephone_number": "515-827-6175",
            "fax_number": "515-827-6189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANS",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "01206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "35739",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada, IA

Sources for this page

Verify at the official NPI Registry.