Active NPI
John William Dircks, M.D.
- Pulmonary Disease Physician
- Kalamazoo, MI
National Provider Identifier
1205930773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- JD028898
- Practice address
- 601 John St
Box 74
Kalamazoo, MI 49007-5341 - Phone
- (269) 341-8481
- Fax
- (269) 341-7781
- NPI assigned
- Sep 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | JD028898 | MI | Primary |
Addresses
Primary practice location
601 John St
Box 74
Kalamazoo, MI 49007-5341
Mailing address
601 John St
Box 42
Kalamazoo, MI 49007-5341
Phone (269) 341-7806
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290C96034 | Other | MI | BC/BS OF MICHIGAN |
| P54696 | Other | MI | BLUECARE NETWORK |
| 382356205105 | Other | MI | COMMUNITY CHOICE OF MICH |
| 290C913410 | Other | BCBS GRP PIN | |
| 4830033 | Other | MI | PHP |
| 4991610 | Medicaid | MI | |
| 4809116 | Other | PHP | |
| 290390908 | Other | BCBS IND PIN | |
| 108097 | Other | GRT LAKES HLTH PLAN | |
| 4379449 | Other | AETNA | |
| 1386445 | Medicaid | MI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JD028898 | MI | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronson Methodist Hospital | Pulmonary Disease | Past | Accepting new patients |
Organizations & group practices 1
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": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252627200000",
"number": "1205930773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "BOX 42",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-341-7806",
"fax_number": "269-341-8743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "BOX 74",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-341-8481",
"fax_number": "269-341-7781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIRCKS",
"first_name": "JOHN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-12",
"last_updated": "2009-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MI",
"license": "JD028898",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MICHIGAN",
"identifier": "290C96034",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE NETWORK",
"identifier": "P54696",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY CHOICE OF MICH",
"identifier": "382356205105",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GRP PIN",
"identifier": "290C913410",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "4830033",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4991610",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "4809116",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IND PIN",
"identifier": "290390908",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GRT LAKES HLTH PLAN",
"identifier": "108097",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4379449",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1386445",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.