NPIMap

Individual provider Active NPI

John Butler Ditchman, D.O.

  • Emergency Medicine Physician
  • Washington, MI
National Provider Identifier
1154410165
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101012503 Issued in MI
Practice address
57662 Grey Fox GLN
Washington, MI 48094-3587
Phone
(586) 786-7319
NPI assigned
Oct 11, 2006
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101012503 MI Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL, IN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050405001040 MI Practitioner - Emergency MedicinePractitioner - General Surgery 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

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Statera Health Care LLCGroup PAC ID 0244565729, 41 clinicians

Practice addresses (Care Compare)

28 Chick St
Metropolis, IL 62960-2467
Phone (618) 427-2680

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Physicians PC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Vituity - Michigan Em PC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Wabash General Hospital District CurrentSince Mar 1, 2026 Accepting new patients
Degara App, PLLC Emergency Medicine CurrentSince Feb 7, 2017 Accepting new patients
Wabash General Hospital District CurrentSince Mar 1, 2026 Accepting new patients
Wabash General Hospital District CurrentSince Mar 1, 2026 Accepting new patients
McLaren Hospital Group Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Interventional Pain Consultants, LLC PastSince Feb 20, 2009 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) 900-3125

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

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

608 Union Chapel Rd
Fort Wayne, IN 46845
Phone (260) 387-0450

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

  • Direct secure messaging: jditchman80150@sih.direct-ci.com

Organizations & group practices 13

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.

View all 13

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1154410165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57662 GREY FOX GLN",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480943587",
            "telephone_number": "586-786-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57662 GREY FOX GLN",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480943587",
            "telephone_number": "586-786-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITCHMAN",
        "first_name": "JOHN",
        "middle_name": "BUTLER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101012503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MI

Sources for this page

Verify at the official NPI Registry.