Individual provider Active NPI

Chad Michael Gerrish, D.O.

  • Internal Medicine Physician
  • Lansing, MI
National Provider Identifier
1063738458
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101018675 Issued in MI
Practice address
1540 Lake Lansing Rd
Suite 102
Lansing, MI 48912-3756
Phone
(517) 913-3810
Fax
(517) 913-3811
NPI assigned
Apr 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101018675 MI Primary

Addresses

Primary practice location

1540 Lake Lansing Rd
Suite 102
Lansing, MI 48912-3756

Mailing address

1540 Lake Lansing Rd
Suite 102
Lansing, MI 48912-3756
Phone (517) 913-3810

Other identifiers 1

IdentifierTypeStateIssuer
1063738458MedicaidMI

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
I20131101001051 MI Practitioner - Internal Medicine 9335374198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLaren Greater LansingGroup PAC ID 7214833466, shared by 4 NPIs, 96 clinicians
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

12805 Escanaba Dr
2 MGL Dewitt Healthcare
Dewitt, MI 48820-8628
Phone (517) 975-9750

5025 Ann Arbor Rd
Jackson, MI 49201-8801
Phone (517) 879-1505

Hospital & facility affiliations

  • McLaren Home Health Home health agency, Lansing, MI, CCN 237008
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Greater Lansing Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1063738458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 LAKE LANSING RD",
            "address_2": "SUITE 102",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123756",
            "telephone_number": "517-913-3810",
            "fax_number": "517-913-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 LAKE LANSING RD",
            "address_2": "SUITE 102",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123756",
            "telephone_number": "517-913-3810",
            "fax_number": "517-913-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERRISH",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-11",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101018675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063738458",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.