NPIMap

Individual provider Active NPI

David J Everingham, D.O.

  • Family Medicine Physician
  • Belleville, MI
National Provider Identifier
1215939244
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DE008308 Issued in MI
Practice address
201 3Rd St Ste 200
Belleville, MI 48111-2605
Phone
(734) 697-9065
NPI assigned
Aug 10, 2005
Last updated
Apr 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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 DE008308 MI Primary

Addresses

Primary practice location

201 3Rd St Ste 200
Belleville, MI 48111-2605

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1863

Other practice location 1

12100 S Huron River Dr
Romulus, MI 48174-1119
Phone (734) 941-1070

Other identifiers 2

IdentifierTypeStateIssuer
1564565MedicaidMI
5820200OtherMIBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address deveringham120513@direct.beaumont.edu

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
I20070309000363 MI Practitioner - General Practice 0749383826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DE008308MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Sep 13, 2011 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Sep 13, 2011 Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

12100 S Huron River Dr
Romulus, MI 48174
Phone (734) 941-1070

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: deveringham120513@direct.beaumont.edu

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, 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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1215939244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1863",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 3RD ST STE 200",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481112605",
            "telephone_number": "734-697-9065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12100 S Huron River Dr",
            "address_purpose": "LOCATION",
            "city": "Romulus",
            "state": "MI",
            "postal_code": "481741119",
            "country_code": "US",
            "telephone_number": "734-941-1070",
            "fax_number": "734-941-1763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVERINGHAM",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DE008308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1564565",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5820200",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deveringham120513@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "201 3rd St Ste 200",
            "city": "Belleville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481112605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, MI

Sources for this page

Verify at the official NPI Registry.