Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MISS CAITLYN N JETTER PA-C
NPI 1053924977
Physician Assistant in Spring Lake, MI

Q: What is Caitlyn Jetter's NPI number?

The NPI number for Caitlyn Jetter is 1053924977. It was assigned to this individual provider in the NPPES registry on August 29, 2020.

Q: What is Caitlyn Jetter's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Caitlyn Jetter was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 29, 2020PECOS Enrolled

17325 VAN WAGONER RD, SPRING LAKE, MI 49456(616) 847-5145(616) 827-4700 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 6, 2026, Nov 10, 2022, Oct 21, 2022 and 3 more (6 updates tracked since 2020).

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About Miss Caitlyn N Jetter Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS CAITLYN N JETTER PA-C (NPI 1053924977) is an individual physician assistant in Spring Lake, Michigan, licensed in Michigan (5601010172) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1053924977

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMISS CAITLYN N JETTERCredential: PA-C

Location Address17325 VAN WAGONER RDSpring Lake, MI 49456-9702

Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000 · Fax (616) 455-5960

Phone(616) 847-5145

Fax(616) 827-4700

Sole ProprietorNo

Enumeration DateAugust 29, 2020

Last NPPES UpdateOctober 20, 20266 updates tracked since enumeration

NPPES CertifiedOctober 20, 2026

✔ NPI 1053924977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MI · 5601010172

Definition

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.

17325 VAN WAGONER RD, Spring Lake, MI 49456

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Secondary Practice Locations 2

Location 1300 68th St SEGrand Rapids, MI 49548-6927 · Phone (616) 455-5000 · Fax (616) 455-5960

Location 21545 68th St SE Ste 200Grand Rapids, MI 49508-7896 · Phone (616) 447-5820

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Caitlyn N Jetter Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49456 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDA ANN JOHNSON LCSW, LMSW

Social Worker (Clinical)