Active NPI
Charles G Kissel DPM PC
- Podiatrist
- Warren, MI
National Provider Identifier
1043498652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- CK000960
- Legal business name
- CHARLES G KISSEL DPM PC
- Practice address
- 29433 Ryan Rd
Warren, MI 48092-2203 - Phone
- (586) 574-0500
- Fax
- (586) 574-2694
- NPI assigned
- Feb 6, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles G Kissel, DPM
- Title
- Partner
- Phone
- (586) 574-0500
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | CK000960 | MI | Primary |
Addresses
Primary practice location
29433 Ryan Rd
Warren, MI 48092-2203
Mailing address
29433 Ryan Rd
Warren, MI 48092-2203
Phone (586) 574-0500
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5137446 | Other | MI | FIRST HEALTH |
| 480F335300 | Other | MI | BCBSM |
| 4949617 | Medicaid | MI | |
| 5987390001 | Other | MI | DME |
| 12268 | Other | MI | M-CARE |
| 21171 | Other | MI | OMNI |
| 2559787 | Other | MI | CIGNA |
| 480Q245670 | Other | MI | BCBSM |
| 1715614 | Medicaid | MI | |
| 480017711 | Other | MI | MCRR |
| 5972192 | Other | MI | AETNA |
| 6087740001 | Other | MI | DME |
| P44714 | Other | MI | B PLUS |
| 480017380 | Other | MI | MCRR |
| P00422721 | Other | MI | MCRR |
| 480E011810 | Other | MI | BCBSM |
National Provider Directory
National Provider Directory- Tax ID family
- Charles G Kissel DPM PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Foot & Ankle Surgery Podiatrist
- Warren, MI
- NPI 1013001221
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Warren, MI
- NPI 1982606414
-
- Podiatrist
- Warren, MI
- NPI 1598767022
-
- Foot & Ankle Surgery Podiatrist
- Bad Axe, MI
- NPI 1316155526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210896000000",
"number": "1043498652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29433 RYAN RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480922203",
"telephone_number": "586-574-0500",
"fax_number": "586-574-2694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29433 RYAN RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480922203",
"telephone_number": "586-574-0500",
"fax_number": "586-574-2694"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLES G KISSEL DPM PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-06",
"last_updated": "2008-05-16",
"status": "A",
"authorized_official_last_name": "KISSEL",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "586-574-0500",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "MI",
"license": "CK000960",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "5137446",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "480F335300",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4949617",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME",
"identifier": "5987390001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M-CARE",
"identifier": "12268",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OMNI",
"identifier": "21171",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2559787",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "480Q245670",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1715614",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCRR",
"identifier": "480017711",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5972192",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME",
"identifier": "6087740001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "B PLUS",
"identifier": "P44714",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCRR",
"identifier": "480017380",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCRR",
"identifier": "P00422721",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "480E011810",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.