Individual provider Active NPI

Erin Jessica Decloux, MD

  • Obstetrics & Gynecology Physician
  • Big Rapids, MI
National Provider Identifier
1083135164
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301113137 Issued in MI
Practice address
722 Locust St Ste 2
Big Rapids, MI 49307-2040
Phone
(231) 592-4200
NPI assigned
Jun 29, 2017
Last updated
Nov 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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 4301113137 MI Primary

Addresses

Primary practice location

722 Locust St Ste 2
Big Rapids, MI 49307-2040

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
I20210607002418 MI Practitioner - Obstetrics/Gynecology 7810267341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Wisconsin School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mecosta County Medical CenterGroup PAC ID 1951215540, 53 clinicians

Practice addresses (Care Compare)

605 Oak St
Big Rapids, MI 49307-2048

722 Locust St
Big Rapids, MI 49307-2040
Phone (616) 754-3001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mecosta County Medical Center CurrentSince Nov 7, 2022 Accepting new patients
Mecosta County Medical Center CurrentSince Nov 7, 2022 Accepting new patients
Mecosta County Medical Center Current Accepting new patients
Pennock Hospital CurrentSince Nov 7, 2022 Accepting new patients
Pennock Hospital CurrentSince Nov 7, 2022 Accepting new patients

Locations

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

722 Locust St
Ste 2
Big Rapids, MI 49307
Phone (231) 592-4200

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

330 Barclay Ave NE
Ste 102
Grand Rapids, MI 49503
Phone (616) 391-1929

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

1005 W Green St
Ste 301
Hastings, MI 49058
Phone (269) 945-2419

Interoperability endpoints

  • Direct secure messaging: edecloux115649@mymichiganhealth.midirect.net
  • Direct secure messaging: edecloux157305@epic00.corewelldirect.org

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.

Hospital & facility affiliations 1

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1083135164",
    "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": "722 LOCUST ST STE 2",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072040",
            "telephone_number": "231-592-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLOUX",
        "first_name": "ERIN",
        "middle_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301113137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.