Individual provider Active NPI

Peter H Viall Jr., MD

  • Family Medicine Physician
  • Bellaire, MI
National Provider Identifier
1265403679
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
059450 Issued in MI
Practice address
4543 S M 88 Hwy
Bellaire, MI 49615-9109
Phone
(231) 533-8661
Fax
(531) 533-6028
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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 059450 MI Primary

Addresses

Primary practice location

4543 S M 88 Hwy
Bellaire, MI 49615-9109

Mailing address

10850 E Traverse Hwy
Ste 4400
Traverse City, MI 49684-1364
Phone (231) 346-6930

Other identifiers 2

IdentifierTypeStateIssuer
080B86010OtherMIBLUE SHIELD
3181320MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101113000237 MI Practitioner - Family Practice 9436162450 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059450MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan, PLLC CurrentSince Jul 2, 2019 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Family Medicine CurrentSince May 29, 2019 Accepting new patients
Sound Inpatient Physicians-Michigan PLLC CurrentSince May 29, 2019 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Family Medicine Current Accepting new patients
Hospitalist Medicine Physicians of Michigan PLLC CurrentSince Jul 2, 2019 Accepting new patients
Hospitalist Medicine Physicians of Michigan - Saginaw PLLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

4543 S M 88 Hwy
Bellaire, MI 49615
Phone (231) 533-8661

1728 S Peninsula Rd
East Jordan, MI 49727
Phone (231) 536-2286

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

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

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1000 Pavilions Cir
Traverse City, MI 49684
Phone (231) 932-3000

Organizations & group practices 6

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1265403679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 E TRAVERSE HWY",
            "address_2": "STE 4400",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496841364",
            "telephone_number": "231-346-6930",
            "fax_number": "231-346-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 S M 88 HWY",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496159109",
            "telephone_number": "231-533-8661",
            "fax_number": "531-533-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIALL",
        "first_name": "PETER",
        "middle_name": "H",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "059450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "080B86010",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3181320",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, MI

Sources for this page

Verify at the official NPI Registry.