NPIMap

Individual provider Active NPI

Henry Kozdron, DO

  • Family Medicine Physician
  • Bad Axe, MI
National Provider Identifier
1295350692
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101027382 Issued in MI
Practice address
684 N Port Crescent St
Bad Axe, MI 48413-1275
Phone
(989) 912-6575
Fax
(989) 912-6013
NPI assigned
Jun 11, 2020
Last updated
Sep 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5151014202 MI
Family Medicine Physician 207Q00000X 5151014202 MI
Family Medicine Physician 207Q00000X 5101027382 MI Primary

Addresses

Primary practice location

684 N Port Crescent St
Bad Axe, MI 48413-1275

Mailing address

684 N Port Crescent St
Bad Axe, MI 48413-1275
Phone (989) 912-6575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101001312 MI Practitioner - Family Practice 2961824776 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4675 Hill St
Cass City, MI 48726-1008
Phone (989) 912-6275

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hills & Dales General Hospital, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Hills & Dales General Hospital, Inc. Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Deckerville Community Hospital Inc Current Accepting new patients
Marlette Regional Hospital Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Dec 8, 2025 Accepting new patients
Mymichigan Medical Center Midland Family Medicine PastSince Jun 1, 2020 Accepting new patients
Hills & Dales General Hospital, Inc. Past Accepting new patients
Mymichigan Medical Center Midland PastSince Jun 1, 2020 Accepting new patients

Locations

684 N Port Crescent St
Bad Axe, MI 48413
Phone (989) 912-6575

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

4675 Hill St
Ste B
Cass City, MI 48726
Phone (989) 912-6112

2030 Black River St
Deckerville, MI 48427
Phone (810) 376-2835

2433 Black River St
Deckerville, MI 48427
Phone (810) 376-2835

2770 Main St
Marlette, MI 48453
Phone (989) 635-4000

Interoperability endpoints

  • Direct secure messaging: hkozdron117588@direct.covenanthealthcare.com
  • Direct secure messaging: hkozdron89753@mymichiganhealth.midirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1295350692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 N PORT CRESCENT ST",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131275",
            "telephone_number": "989-912-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 N PORT CRESCENT ST",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131275",
            "telephone_number": "989-912-6575",
            "fax_number": "989-912-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZDRON",
        "first_name": "HENRY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151014202",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151014202",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101027382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bad Axe, MI

Sources for this page

Verify at the official NPI Registry.