KELLY M JENSEN (NPI# 1326131335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326131335 |
| Entity Type | Individual |
| Full Name | KELLY M JENSEN |
| Credential | PA-C |
| Practice Address |
6401 Prairie St Suite 2300 Norton Shores MI 49444-7840 |
| Mailing Address |
Po Box 1847 Muskegon MI 49443-1847 |
| Practice Telephone | 2317277928 |
| Practice Fax Number | 2317247844 |
| Mailing Telephone | 2317277948 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2019-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601003267 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
5601003267 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE PTAN | N34010012 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386241511 | Kelly Jensen | Counselor | 255 Delaware Ave Ste 3000, Buffalo, NY 14202-2016 | 2020-10-01 |
| 1831706795 | Kelly Jensen | Midwife | 1745 Harold Rd, Escondido, CA 92026-1822 | 2020-09-24 |
| 1548645245 | Kelly Jensen | Specialist | 19 Mallard Ave, Selden, NY 11784-2309 | 2015-07-23 |
| 1548670698 | Kelly Jensen | Social Worker | 314 5th St W, Ste. 1, Bottineau, ND 58318-1204 | 2014-04-29 |
| 1255834057 | Kelly Jensen | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2018-03-17 |
| 1013368190 | Kelly Jensen | Physical Therapy Assistant | 801 S Briggs St, 2nd Floor, Joliet, IL 60433-9591 | 2016-06-29 |
| 1326388612 | Kelly M Jensen | Counselor | 619 N 500 W, Provo, UT 84601-1547 | 2013-02-22 |
| 1033455845 | Kelly Ann Jensen | Nurse Practitioner | 3920 Outlook Rd, Sunnyside, WA 98944-9202 | 2012-12-26 |
| 1497955330 | Kelly D Jensen | Orthopaedic Surgery | 280 N Hospital Dr, Price, UT 84501-4216 | 2007-07-19 |
| 1568446227 | Kelly Elizabeth Clark Jensen | Obstetrics & Gynecology | 4745 Arapahoe Ave, Suite 200, Boulder, CO 80303-1080 | 2005-12-05 |
| Street Address |
6401 PRAIRIE ST SUITE 2300 |
| City | NORTON SHORES |
| State | MI |
| Zip Code | 49444-7840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700410446 | Ashley Goodsmith | Physician Assistant | 6401 Prairie St, Norton Shores, MI 49444-7840 | 2020-03-02 |
| 1962068544 | Liberty Anne Abraham | Nurse Practitioner | 6401 Prairie St, Norton Shores, MI 49444-7840 | 2019-05-19 |
| 1962977702 | Julie Ann Juntunen | Nurse Practitioner | 6401 Prairie St, Norton Shores, MI 49444-7840 | 2018-10-08 |
| 1437604212 | Hillary Ann Bickel | Physician Assistant | 6401 Prairie St, Suite 1600, Norton Shores, MI 49444-7840 | 2016-08-22 |
| 1730571100 | Mercy Health Partners | Prosthetic/Orthotic Supplier | 6401 Prairie St, Suite 2900, Norton Shores, MI 49444-7840 | 2015-02-23 |
| 1174924948 | Alicia A Gappa | Nurse Practitioner | 6401 Prairie St, Suite 1600, Norton Shores, MI 49444-7840 | 2014-09-11 |
| 1558709964 | Kelly A Flynn | Family Medicine | 6401 Prairie St, Suite 2600, Norton Shores, MI 49444-7840 | 2013-06-07 |
| 1922445022 | Jennifer Kay Dulaney | Family Medicine | 6401 Prairie St, Suite 1600, Norton Shores, MI 49444-7840 | 2013-05-29 |
| 1952664583 | Alex Francis Wagner | Family Medicine | 6401 Prairie St, Suite 1600, Norton Shores, MI 49444-7840 | 2012-06-19 |
| 1184911596 | Jennifer Lynn Mosher | Nurse Practitioner | 6401 Prairie St, Suite 2300, Norton Shores, MI 49444-7840 | 2011-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073084349 | Cathy Forrest, Ma, LLP Plc | Psychologist | 255 Seminole Road, Suite-205, Muskegon, MI 49444 | 2018-12-16 |
| 1831687276 | Sarah J Weiden | Massage Therapist | 1040 E Sternberg Rd, Muskegon, MI 49444 | 2018-04-30 |
| 1184131500 | Hatem M Gelani Sr. | Dentist | 1725 E Sherman Blvd, Muskegon, MI 49444 | 2018-01-08 |
| 1497123673 | Rite Aid | Pharmacist | 2213 E Hile Road, Muskegon, MI 49444 | 2015-09-04 |
| 1689077075 | Rosa Carpenter-parker | Counselor | 445 East Sherman, Muskegon, MI 49444 | 2014-09-30 |
| 1417373036 | Smile Center Pllc | Dentist | 3500 Park Street, Smile Center Pllc, Muskegon, MI 49444 | 2014-03-06 |
| 1134460439 | Adam L Powell | Physical Medicine & Rehabilitation | 1675 E Mount Garfield Rd, Muskegon, MI 49444 | 2013-03-12 |
| 1972847135 | Kristen Haugh | Physical Therapist | 5251 Harvey St Ste 100, Norton Shores, MI 49444 | 2012-11-12 |
| 1912261694 | Brandon D Freel | Obstetrics & Gynecology | 6401 Prairie St Ste 2100, Norton Shores, MI 49444 | 2012-06-27 |
| 1437434487 | Amy Stegall | Pharmacist | 1171 E Sherman, Norton Shores, MI 49444 | 2011-10-20 |
| Find all providers in zip 49444 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427162023 | George Earl Mclaughlin | Physician Assistant | 1450 Farr Rd Ste 5000, Norton Shores, MI 49444-7789 | 2006-08-19 |
| 1295749463 | Dana Jo Cochrane - Hoekstra | Physician Assistant | 131 W Seaway Dr, Suite 200, Norton Shores, MI 49444-3759 | 2006-07-27 |
| 1669424719 | Angela L Beezley | Physician Assistant | 6425 S. Harvey St., Norton Shores, MI 49444-9739 | 2006-05-17 |
| 1629055405 | Brian L Akre | Physician Assistant | 6401 Prairie St Ste 2600, Norton Shores, MI 49444 | 2005-12-22 |
| 1700410446 | Ashley Goodsmith | Physician Assistant | 6401 Prairie St, Norton Shores, MI 49444-7840 | 2020-03-02 |
| 1437604212 | Hillary Ann Bickel | Physician Assistant | 6401 Prairie St, Suite 1600, Norton Shores, MI 49444-7840 | 2016-08-22 |
| 1861868580 | Chelsie R Morris | Physician Assistant | 3535 Park St Ste 110, Norton Shores, MI 49444-3736 | 2015-08-17 |
| 1346514304 | Leah E Lillmars | Physician Assistant | 6225 Prairie St, Norton Shores, MI 49444-7831 | 2012-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
| City | NORTON SHORES |
| Zip Code | 49444 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.