Individual provider Active NPI

Daniel M Webster, MD

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1164571493
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301039453 Issued in MI
Practice address
1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone
(231) 935-8000
Fax
(231) 935-8099
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 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 4301039453 MI Primary

Addresses

Primary practice location

1400 Medical Campus Dr
Traverse City, MI 49684-7823

Mailing address

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

Other practice location 1

1221 Sixth St Ste 208
Traverse City, MI 49684-2360
Phone (231) 935-2045

Other identifiers 2

IdentifierTypeStateIssuer
3155939MedicaidMI
A73597OtherMIPRIORITY HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1164571493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MEDICAL CAMPUS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847823",
            "telephone_number": "231-935-8000",
            "fax_number": "231-935-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MEDICAL CAMPUS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847823",
            "telephone_number": "231-935-8000",
            "fax_number": "231-935-8099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Sixth St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842360",
            "country_code": "US",
            "telephone_number": "231-935-2045",
            "fax_number": "231-935-2046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "DANIEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301039453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3155939",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "A73597",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.