Individual provider Active NPI

Eric Omron, CCAR, CPRM, CADC-DP

  • Addiction (Substance Use Disorder) Counselor
  • Boyne Falls, MI
National Provider Identifier
1174359152
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2329 Center St
Boyne Falls, MI 49713-9268
Phone
(231) 535-2822
NPI assigned
Sep 9, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

2329 Center St
Boyne Falls, MI 49713-9268

Mailing address

2329 Center St
Boyne Falls, MI 49713-9268

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Walloon Lake Recovery Lodge, LLC CurrentSince Sep 15, 2024 Accepting new patients
Bear River Primary Care CurrentSince Sep 15, 2024 Accepting new patients

Locations

2329 Center St
Boyne Falls, MI 49713
Phone (231) 758-4566

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21307/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1174359152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 CENTER ST",
            "city": "BOYNE FALLS",
            "state": "MI",
            "postal_code": "497139268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 CENTER ST",
            "city": "BOYNE FALLS",
            "state": "MI",
            "postal_code": "497139268",
            "telephone_number": "231-535-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMRON",
        "first_name": "ERIC",
        "credential": "CCAR, CPRM, CADC-DP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boyne Falls, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.