Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Noah King

Individual provider Physician Assistant · NPI 1417797606

Noah King is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2024, 2 years ago. Practices with Great Lakes Neurosurgical Associates PC, a 13-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
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Practice location Address checks out

3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570
Phone: (616) 454-3465
Fax: (616) 454-9004
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1417797606
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 28, 2024
Last updated in NPPESMay 28, 2024
Certification dateMay 24, 2024
Mailing address3350 Eagle Park Dr Ne Ste 102, Grand Rapids, MI 49525-4570

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Great Lakes Neurosurgical Associates Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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