Individual provider Active NPI

John Jerius, MD

  • Surgery Physician
  • Warren, MI
National Provider Identifier
1306848353
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301080979 Issued in MI
Practice address
27150 Ryan Rd
Warren, MI 48092-5124
Phone
(586) 693-3821
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301080979 MI Primary

Addresses

Primary practice location

27150 Ryan Rd
Warren, MI 48092-5124

Mailing address

PO Box 1048
Warren, MI 48090-1048

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

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Memorial Hospital CurrentSince Mar 4, 2019 Accepting new patients
Drew Surgical Services LLC Surgery CurrentSince Jun 23, 2015 Accepting new patients
Delta Memorial Hospital CurrentSince Mar 4, 2019 Accepting new patients
Northeast Surgical Associates, PC Surgery PastSince Apr 25, 2005 Accepting new patients

Locations

811 Highway 65 S
Dumas, AR 71639
Phone (870) 382-4303

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

778 Scogin Dr
Spc Llc
Monticello, AR 71655
Phone (870) 460-3515

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/deltamh-91f47cd8

Organizations & group practices 4

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1306848353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1048",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480901048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27150 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925124",
            "telephone_number": "586-693-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERIUS",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301080979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.