NPIMap

Individual provider Active NPI

Dana Andre Dewitt, DO

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1124016639
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101012782 Issued in MI
Practice address
300 W Washington Ave
Ste 150
Jackson, MI 49201-2180
Phone
(517) 783-4664
Fax
(517) 783-4698
NPI assigned
Oct 10, 2005
Last updated
Oct 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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 5101012782 MI Primary

Addresses

Primary practice location

300 W Washington Ave
Ste 150
Jackson, MI 49201-2180

Mailing address

300 W Washington Ave
Ste 150
Jackson, MI 49201-2180
Phone (517) 783-4664

Other identifiers 3

IdentifierTypeStateIssuer
0120233OtherPHYSCIAN HEALTH PLAN MA
4080108MedicaidMI
700C86358OtherBCBS MI

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
I20120423000732 MI Practitioner - Family Practice 1355363771 Reassigns benefits to 1 organization
Practice locations: Jackson, MI

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Area Health CenterGroup PAC ID 3577560846, 20 clinicians

Practice addresses (Care Compare)

436 W Main St
Hale Clinic
Hale, MI 48739-9246
Phone (989) 728-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101012782MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John F Smarch DC PC CurrentSince Mar 1, 2005 Accepting new patients
Sterling Area Health Center CurrentSince Jun 10, 2024 Accepting new patients
Sterling Area Health Center Current Accepting new patients
Sterling Area Health Center CurrentSince Jun 10, 2024 Accepting new patients
Sterling Area Health Center Past Accepting new patients

Locations

436 W Main St
Hale, MI 48739
Phone (989) 728-2800

300 W Washington Ave
Ste 150
Jackson, MI 49201
Phone (517) 783-4664

1827 Greenwood Rd
Prescott, MI 48756
Phone (989) 873-6200

1064 W Cedar St
Standish, MI 48658
Phone (866) 792-2792

725 E State St
Sterling, MI 48659
Phone (517) 654-2491

621 Court St
Ste 102
West Branch, MI 48661
Phone (989) 343-9466

Interoperability endpoints

  • Direct secure messaging: dana.dewitt.p1@direct.sterlinghealth.nextgenshare.com
  • Direct secure messaging: ddewitt451772@direct.hfhs.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 8

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1124016639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "STE 150",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-783-4664",
            "fax_number": "517-783-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "STE 150",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-783-4664",
            "fax_number": "517-783-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "DANA",
        "middle_name": "ANDRE",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101012782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSCIAN HEALTH PLAN MA",
            "identifier": "0120233",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4080108",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "700C86358",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.