Individual provider Active NPI

Erin Nicole Deprekel, DO

  • Family Medicine Physician
  • Iron Mountain, MI
National Provider Identifier
1245768951
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101026481 Issued in MI
Practice address
1711 S Stephenson Ave Ste 210
Iron Mountain, MI 49801-3649
Phone
(517) 205-3998
Fax
(517) 205-7050
NPI assigned
May 24, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 5101026481 MI
Student in an Organized Health Care Education/Training Program 390200000X 5101023100 MI
Family Medicine Physician 207Q00000X 5101026481 MI Primary

Addresses

Primary practice location

1711 S Stephenson Ave Ste 210
Iron Mountain, MI 49801-3649

Mailing address

1283 Timber Ridge Rd
Iron Mountain, MI 49801-9419
Phone (517) 294-6803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006000528 MI Practitioner - General Practice 0941578041 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101023100MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Dickinson County Healthcare System Neuromusculoskeletal Medicine & Omm CurrentSince Sep 1, 2021 Accepting new patients

Locations

1711 S Stephenson Ave
Ste 210
Iron Mountain, MI 49801
Phone (906) 776-5800

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

1010 Olive Ave
Florence, WI 54121
Phone (715) 528-4775

Interoperability endpoints

  • Direct secure messaging: erin.deprekel.1@22710.direct.athenahealth.com
  • Direct secure messaging: erin.deprekel@marshfieldclinichealthsystem.cernerdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245768951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1283 TIMBER RIDGE RD",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498019419",
            "telephone_number": "517-294-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 210",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013649",
            "telephone_number": "517-205-3998",
            "fax_number": "517-205-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPREKEL",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2022-07-21",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101026481",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101023100",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101026481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.