Joseph Marvyn Neri, D.O.
Individual provider Active NPI Emergency Medicine Physician · Saint Ignace, MI
NPI 1023022902 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023022902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 5101013054 (MI)
- Practice address
- 220 Burdette St
Saint Ignace, MI 49781-1712 - Phone
- (906) 643-8585
- Fax
- (906) 643-9036
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050802000562 | MI | Practitioner - Family Practice | 3971530650 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101013054 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mymichigan Medical Center Sault | Current | Accepting new patients | |
| Mymichigan Medical Center Sault | Current |
Accepting new patients | |
| Mackinac Straits Health System Inc | Emergency Medicine | Current | Accepting new patients |
| Mackinac Straits Health System Inc | Family Medicine | Current |
Accepting new patients |
| Mymichigan Medical Center Sault | Current |
Accepting new patients | |
| Mackinac Straits Health System Inc | Emergency Medicine | Current |
Accepting new patients |
| Community Memorial Hospital | Past | Accepting new patients | |
| Community Memorial Hospital | Past | Accepting new patients | |
| Mymichigan Medical Center Sault | Family Medicine | Past | Accepting new patients |
Locations
16523 S Water Tower Dr
Kincheloe, MI 49788
Phone (906) 495-1344
4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956
502 W Harrie St
Newberry, MI 49868
Phone (906) 293-9131
1140 N State St
Saint Ignace, MI 49781
Phone (906) 643-0466
500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350
Interoperability endpoints
- mneri128295@mymichiganhealth.midirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101013054 | MI | Yes |
Addresses
Primary practice location
220 Burdette St
Saint Ignace, MI 49781-1712
Mailing address
2515 Harrison Ave Apt 404
Cheboygan, MI 49721-1377
Phone (906) 643-8585
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4310155 | Medicaid | MI |
Other providers in Saint Ignace, MI
- Michael W Johnson, MD, PC
- Krystal Lorraine Mittelsteadt
- Kathryn E Mizzi
- Moses Dialysis Unit
- Deborah Narrin
- Nicholas R Newhouse
- Mary Joe North
- Donna Marie Nye I
- Beverly S. Osborne
- Brent Richard Paape
All providers in Saint Ignace, MI · Emergency Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.