Jennifer Lackman, PA
NPI 1184015414 · Physician Assistant · Grand Rapids, MI
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jennifer Lackman, PA is a Physician Assistant provider in Grand Rapids, MI (NPI 1184015414).
Provider details
- NPI number
- 1184015414
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- 5601007301 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-02-09
- Last updated
- 2022-04-06
- Certified
- 2022-04-06
Frequently asked questions
- What is Jennifer Lackman's NPI number?
- Jennifer Lackman's National Provider Identifier (NPI) is 1184015414, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jennifer Lackman's specialty?
- Jennifer Lackman is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Jennifer Lackman located?
- Jennifer Lackman's practice location on file with NPPES is 310 Lafayette Ave Se, Grand Rapids, MI 49503-4693.
- What is Jennifer Lackman's phone number?
- The practice phone number listed in the NPPES registry for Jennifer Lackman is (616) 685-8200.
- Does Jennifer Lackman accept Medicare?
- Jennifer Lackman is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jennifer Lackman's NPI active?
- Yes — Jennifer Lackman's NPI (1184015414) is active in the NPPES registry as of the last update on 2022-04-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.