NPIMap

Individual provider Active NPI

Neesha Elizabeth Fournier, MD

  • Internal Medicine Physician
  • Traverse City, MI
National Provider Identifier
1194988402
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301095792 Issued in MI
Practice address
5041 N Royal Dr
Traverse City, MI 49684-6986
Phone
(231) 935-0600
Fax
(231) 935-0613
NPI assigned
Jul 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301095792 MI Primary
Internal Medicine Physician 207R00000X 52450 WI

Addresses

Primary practice location

5041 N Royal Dr
Traverse City, MI 49684-6986

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-0600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address neesha.fournier@mmp.eclinicaldirectplus.com

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
I20100702000430 MI Practitioner - Internal Medicine 6507923208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Human Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians

Practice addresses (Care Compare)

5041 N Royal Dr
Traverse City, MI 49684-6986
Phone (231) 935-0600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301095792MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Internal Medicine CurrentSince May 20, 2019 Accepting new patients
Munson Medical Group Internal Medicine Current Accepting new patients
Munson Medical Group CurrentSince Jan 1, 2020 Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Medical Center CurrentSince May 20, 2019 Accepting new patients
Indigo Hospital Medicine - Traverse City, PLC Internal Medicine Past Accepting new patients
Indigo Services, PLC Internal Medicine Past Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

2891 Momentum Pl
Chicago, IL 60689

5041 N Royal Dr
Traverse City, MI 49684
Phone (231) 392-8400

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

224 Circle Dr
Traverse City, MI 49684
Phone (231) 932-4912

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

Interoperability endpoints

  • Direct secure messaging: nfournier@direct.mhc.net

Organizations & group practices 9

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 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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1194988402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-0600",
            "fax_number": "231-932-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846986",
            "telephone_number": "231-935-0600",
            "fax_number": "231-935-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURNIER",
        "first_name": "NEESHA",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301095792",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "52450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "neesha.fournier@mmp.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "224 Circle Drive",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.