NPIMap

Individual provider Active NPI

Nathan Dills, DO

  • Family Medicine Physician
  • Fruitport, MI
National Provider Identifier
1114500790
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5151015237 Issued in MI
Practice address
3443 Farr Rd
Fruitport, MI 49415-8779
Phone
(231) 672-2900
NPI assigned
May 3, 2021
Last updated
May 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5151015237 MI Primary

Addresses

Primary practice location

3443 Farr Rd
Fruitport, MI 49415-8779

Mailing address

1675 Leahy St Ste 315a
Muskegon, MI 49442-5543
Phone (231) 672-8284

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106000725 MI Practitioner - Family Practice 4688108269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

1150 E Sherman Blvd
Suite 1175
Muskegon, MI 49444-1885
Phone (231) 672-2900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151015237MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Network Family Medicine CurrentSince Oct 15, 2024 Accepting new patients
Hospice of Muskegon County, Inc. Current Accepting new patients
Mercy Physician Network Family Medicine CurrentSince Oct 15, 2024 Accepting new patients
Hospice of Muskegon County, Inc. Family Medicine Current Accepting new patients
Christian Care Past Accepting new patients

Locations

3443 Farr Rd
Fruitport, MI 49415
Phone (231) 672-2900

1150 E Sherman Blvd
Ste 1100
Muskegon, MI 49444
Phone (231) 672-1690

1675 Leahy St
Ste 315A
Muskegon, MI 49442
Phone (231) 672-7800

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

1150 E Sherman Blvd
Ste 1175
Norton Shores, MI 49444
Phone (231) 672-6740

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13864/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.

Hospital & facility affiliations 7

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": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1114500790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 315A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425543",
            "telephone_number": "231-672-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 FARR RD",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494158779",
            "telephone_number": "231-672-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLS",
        "first_name": "NATHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151015237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitport, MI

Sources for this page

Verify at the official NPI Registry.