NPIMap

Organization Active NPI

Brent J Raap DO PC

  • Family Medicine Physician
  • Pinconning, MI
National Provider Identifier
1083837736
Registry record updated Dec 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013384 Issued in MI
Legal business name
BRENT J RAAP DO PC
Practice address
4293 N Huron Road
Pinconning, MI 48650
Phone
(989) 879-6244
Fax
(989) 879-1092
NPI assigned
Apr 11, 2007
Last updated
Dec 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2009

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

Authorized official

Name
Brent J Raap, DONPI 1780678110
Title
Doctor
Phone
(989) 879-6244

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)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013384 MI Primary

Addresses

Primary practice location

4293 N Huron Road
Pinconning, MI 48650

Mailing address

4293 N Huron Road
Pinconning, MI 48650
Phone (989) 879-6244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040609001042 MI Part B Supplier - Clinic/Group Practice 0547243750 Receives reassigned benefits from 2 practitioners
Practice locations: Pinconning, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0891669Brent J Raap DO4293 N Huron Road Suite 1, Pinconning, MI 48650Provider-performed microscopySep 12, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261267200000",
    "number": "1083837736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4293 N HURON ROAD",
            "city": "PINCONNING",
            "state": "MI",
            "postal_code": "48650",
            "telephone_number": "989-879-6244",
            "fax_number": "989-879-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4293 N HURON ROAD",
            "city": "PINCONNING",
            "state": "MI",
            "postal_code": "48650",
            "telephone_number": "989-879-6244",
            "fax_number": "989-879-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT J RAAP DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2009-12-20",
        "status": "A",
        "authorized_official_last_name": "RAAP",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "989-879-6244",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinconning, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.