NPIMap

Organization Active NPI

Bret G. Autrey D.O., PLLC

  • Surgery Physician
  • Ludington, MI
National Provider Identifier
1003832072
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101014946 Issued in MI
Legal business name
BRET G. AUTREY D.O., PLLC
Practice address
7 N Atkinson Dr
Suite 112
Ludington, MI 49431-1953
Phone
(231) 843-3717
Fax
(231) 845-6198
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bret Gregory Autrey, D.O.
Title
Owner
Phone
(231) 843-3717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 5101014946 MI Primary

Addresses

Primary practice location

7 N Atkinson Dr
Suite 112
Ludington, MI 49431-1953

Mailing address

7 N Atkinson Dr
Suite 112
Ludington, MI 49431-1953
Phone (231) 843-3717

Other identifiers 1

IdentifierTypeStateIssuer
4926720MedicaidMI

National Provider Directory

National Provider Directory

Locations

7 Atkinson Dr
Ste 112
Ludington, MI 49431
Phone (231) 843-3717

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1003832072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N ATKINSON DR",
            "address_2": "SUITE 112",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3717",
            "fax_number": "231-845-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 N ATKINSON DR",
            "address_2": "SUITE 112",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3717",
            "fax_number": "231-845-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRET G. AUTREY D.O., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "AUTREY",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-843-3717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101014946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4926720",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.