Individual provider Active NPI

Debbera J Speeter, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1063482537
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
4704119224 Issued in MI
Practice address
7110 Stadium Dr
Kalamazoo, MI 49009
Phone
(269) 488-8844
Fax
(269) 488-8845
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704119224 MI
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 4704119224 MI Primary

Addresses

Primary practice location

7110 Stadium Dr
Kalamazoo, MI 49009

Mailing address

7110 Stadium Dr # 42
Kalamazoo, MI 49009-9423
Phone (269) 488-8844

Other practice location 1

3300 W Centre Ave
Bronson OB GYN Associates
Portage, MI 49024-4666
Phone (269) 327-2211

Other identifiers 2

IdentifierTypeStateIssuer
4500721MedicaidMI
(D) 4500712MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704119224MIMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Women'S Health, P.C. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1063482537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 STADIUM DR # 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099423",
            "telephone_number": "269-488-8844",
            "fax_number": "269-488-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49009",
            "telephone_number": "269-488-8844",
            "fax_number": "269-488-8845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 W Centre Ave",
            "address_2": "Bronson OB GYN Associates",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490244666",
            "country_code": "US",
            "telephone_number": "269-327-2211",
            "fax_number": "269-327-0273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEETER",
        "first_name": "DEBBERA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704119224",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MI",
            "license": "4704119224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4500721",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "(D) 4500712",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.