Individual provider Active NPI

David Eugene Eggert, MD

  • Vascular Surgery Physician
  • Jackson, MI
National Provider Identifier
1245223874
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301043561 Issued in MI
Practice address
1100 E Michigan Ave
Suite 310
Jackson, MI 49201-1847
Phone
(517) 788-6968
Fax
(517) 796-9122
NPI assigned
Aug 30, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301043561 MI
Vascular Surgery Physician 2086S0129X 4301043561 MI Primary

Addresses

Primary practice location

1100 E Michigan Ave
Suite 310
Jackson, MI 49201-1847

Mailing address

1100 E Michigan Ave
Suite 310
Jackson, MI 49201-1847
Phone (517) 788-6968

Other identifiers 7

IdentifierTypeStateIssuer
P58588OtherBCN (HEALTH PLAN)
105036OtherCARE CHOICES/PREFERRED
0203806701OtherMIBCBS OF MI
100913OtherGREAT LAKES HEALTH PLAN
2114910MedicaidMI
4599487OtherAETNA (HEALTH PLANS)
1720063OtherMIPHP (HEALTH PLAN)

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245223874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "address_2": "SUITE 310",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011847",
            "telephone_number": "517-788-6968",
            "fax_number": "517-796-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "address_2": "SUITE 310",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011847",
            "telephone_number": "517-788-6968",
            "fax_number": "517-796-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGERT",
        "first_name": "DAVID",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301043561",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301043561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN (HEALTH PLAN)",
            "identifier": "P58588",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES/PREFERRED",
            "identifier": "105036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "0203806701",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "100913",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2114910",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA (HEALTH PLANS)",
            "identifier": "4599487",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP (HEALTH PLAN)",
            "identifier": "1720063",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.