John Butler Ditchman, D.O.
Individual provider Active NPI Emergency Medicine Physician · Washington, MI
NPI 1154410165 · NPPES record last updated Sep 10, 2026
Key facts
- NPI
- 1154410165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 5101012503 (MI)
- Practice address
- 57662 Grey Fox GLN
Washington, MI 48094-3587 - Phone
- (586) 786-7319
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 13
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Statera Health Care LLC
Practice addresses (Care Compare)
28 Chick St
Metropolis, IL 62960-2467
Phone (618) 427-2680
Hospital & facility affiliations
- McLaren Caro Region
- Harrisburg Medical Center
- Wabash General Hospital 1
- Parkview Whitley Hospital
- McLaren Thumb Region
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MI, IL, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050405001040 | MI | Practitioner - Emergency Medicine |
5395792022 | Reassigns benefits to 4 organizations |
| I20240731003002 | IL | Practitioner - Emergency Medicine | 5395792022 | Reassigns benefits to 3 organizations |
| I20241004000948 | IN | Practitioner - Emergency Medicine | 5395792022 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101012503 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Degara App, PLLC | Emergency Medicine | Current |
Accepting new patients |
| McLaren Hospital Group | Emergency Medicine | Current |
Accepting new patients |
| Vituity - Michigan Em PC | Emergency Medicine | Current |
Accepting new patients |
| Wabash General Hospital District | Current |
Accepting new patients | |
| Wabash General Hospital District | Current |
Accepting new patients | |
| Wabash General Hospital District | Current |
Accepting new patients | |
| Professional Emergency Physicians PC | Emergency Medicine | Current |
Accepting new patients |
| Interventional Pain Consultants, LLC | Past |
Accepting new patients | |
| Detroit Osteopathic Hospital Corporation | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
911 Stacey Burk Dr
Flora, IL 62839
Phone (618) 662-2161
1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621
416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141
608 Union Chapel Rd
Fort Wayne, IN 46845
Phone (260) 482-4440
2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000
1100 S Van Dyke Rd
Bad Axe, MI 48413
Phone (989) 269-9521
321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840
401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000
401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286
50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300
Interoperability endpoints
- jditchman80150@sih.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101012503 | MI | Yes |
Addresses
Primary practice location
57662 Grey Fox GLN
Washington, MI 48094-3587
Mailing address
57662 Grey Fox GLN
Washington, MI 48094-3587
Phone (586) 786-7319
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3391239 | Medicaid | MI |
Other providers in Washington, MI
- Ashley Davidson
- Thomas Michael Davidson
- Brittany Kathleen Davis
- Julia Alice Davis
- Hayley Deboyer
- Shannon Doran
- Jadyn Nicole Drobek
- Lori Marie Dunn
- Alex Dusza
- Edgar Cruz M.D. P.C.
All providers in Washington, MI · Emergency Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.