Individual provider Active NPI

Tami Joy Michele, DO

  • Obstetrics & Gynecology Physician
  • Grand Rapids, MI
National Provider Identifier
1053525733
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101015745 Issued in MI
Practice address
426 Michigan St NE
Grand Rapids, MI 49503
Phone
(616) 391-3302
NPI assigned
May 10, 2007
Last updated
Aug 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101015745 MI Primary

Addresses

Primary practice location

426 Michigan St NE
Grand Rapids, MI 49503

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000599 MI Practitioner - Obstetrics/Gynecology 9032210067 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Newaygo County General Hospital Association CurrentSince May 2, 2016 Accepting new patients
John P Lagrand M D P C Obstetrics & Gynecology CurrentSince Feb 23, 2019 Accepting new patients
Newaygo County General Hospital Association Current Accepting new patients
Womens Health Collective Past Accepting new patients
Mercy Urgent Care Obstetrics & Gynecology Past Accepting new patients

Locations

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

230 Michigan St NE
Ste 102
Grand Rapids, MI 49503
Phone (616) 459-8088

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

Interoperability endpoints

  • Direct secure messaging: tami.michele.1@20679.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20679/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1053525733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-391-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELE",
        "first_name": "TAMI",
        "middle_name": "JOY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101015745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.