JILL A NOACK PA C NPI 1891788261

NPI Information

NPI: 1891788261
Provider Name: JILL A NOACK, PA C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
145 MICHIGAN ST NE
SUITE 3100
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 954-9800
Get Directions

Jill A Noack, PA C is a medical physician assistant in Grand Rapids, MI. Jill A Noack, PA C NPI is 1891788261. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

145 MICHIGAN ST NE
SUITE 3100
GRAND RAPIDS, MI
ZIP 49503-562
Phone: (616) 954-9800
Fax: (616) 954-2116

The NPI 1891788261 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/31/2005 and was last updated on 1/12/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		5601001749	MICHIGAN	No
2	363AS0400X	Physician Assistant	Surgical	5601001749	MICHIGAN	No
3	363AM0700X	Physician Assistant	Medical	5601001749	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	383148262	OTHER		EIN-HEALTHCARE MIDWEST
2	7N66660011	MEDICARE PIN
3	P00368280	MEDICARE PIN	MICHIGAN
4	S94795	MEDICARE UPIN
5	0C91143	OTHER	MICHIGAN	BCBSM
6	0N83160003	MEDICARE PIN	MICHIGAN
7	CA3050	OTHER	MICHIGAN	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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