Phillip W Niemi, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101008398 Issued in MI

Practice address

550 Osborn Blvd
Suite #202
Sault Sainte Marie, MI 49783-1899

Phone

(906) 632-1100

Fax

(906) 632-7768

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1245280130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 OSBORN BLVD",
            "address_2": "SUITE #202",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831899",
            "telephone_number": "906-632-1100",
            "fax_number": "906-632-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 OSBORN BLVD",
            "address_2": "SUITE #202",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831899",
            "telephone_number": "906-632-1100",
            "fax_number": "906-632-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMI",
        "first_name": "PHILLIP",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101008398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2120652",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Nelson, LMSW
• Kathryn Neubert
• Jodi Marie Newell
• Patricia Ann Newhouse, M.D.
• Paula Nichols, NP
• Alexandra Nisbet
• Bridget Nodurft, R.N.
• Hannah Corinne Nolan, PT, DPT
• Elizabeth A Noland, MNT
• Northern Michigan Emergenc Physicians, LLP

• Family Medicine Physician in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.