Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jennifer Vanderwall, PA-C

Individual provider Physician Assistant · NPI 1033149638

Jennifer Vanderwall, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2005, 21 years ago. Practices with Visionary Medical Services, PC, a 63-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
21
Licensed in
MI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone: (616) 391-1680
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601004566 (MI)

Record details

NPI number1033149638
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 3, 2006
Last updated in NPPESNovember 2, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Visionary Medical Services, Pc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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