Active NPI
Katherine Ackerman, DO
- Gynecologic Oncology Physician
- Pontiac, MI
National Provider Identifier
1306530902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecologic Oncology Physician
- License
- 5151016432
- Practice address
- 44405 Woodward Ave
Pontiac, MI 48341-5023 - Phone
- (248) 858-3231
- NPI assigned
- Jun 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecologic Oncology Physician | 207VX0201X | 5151016432 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Ave
Pontiac, MI 48341-5023
Mailing address
44405 Woodward Ave
Pontiac, MI 48341-5023
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230809000921 | MI | Order and Referring Only - Obstetrics/Gynecology | 1658733530 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5151016432 | MI | MD | Gynecologic Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1306530902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-3231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERMAN",
"first_name": "KATHERINE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-06",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0201X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": "MI",
"license": "5151016432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.