Individual provider Active NPI

Ronald H Bissett, MD

  • Family Medicine Physician
  • Escanaba, MI
National Provider Identifier
1265441687
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301043571 Issued in MI
Practice address
3401 Ludington St
Escanaba, MI 49829-1300
Phone
(906) 786-5707
Fax
(906) 786-4004
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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 4301043571 MI Primary

Addresses

Primary practice location

3401 Ludington St
Escanaba, MI 49829-1300

Mailing address

3409 Ludington St
Suite 104
Escanaba, MI 49829-4212
Phone (906) 428-5403

Other identifiers 2

IdentifierTypeStateIssuer
4178698MedicaidMI
0210016OtherMIBCBS PIN

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1265441687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON ST",
            "address_2": "SUITE 104",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498294212",
            "telephone_number": "906-428-5403",
            "fax_number": "906-789-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291300",
            "telephone_number": "906-786-5707",
            "fax_number": "906-786-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSETT",
        "first_name": "RONALD",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301043571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4178698",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0210016",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.