Audrey Liston, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101012074 Issued in MI

Practice address

787 Market St Ste 9
Hancock, MI 49930

Phone

(906) 482-7762

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Up Health System Home Care and Hospice Portage Home health agency, Houghton, MI, CCN 237262
• Aspirus at Home Home health agency, Hancock, MI, CCN 237212
• Aspirus at Home Hospice, Hancock, MI, CCN 231560

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684

  Family Medicine

  Medicare reassignment NPD
• Portage Physician Practices Inc

  • Rural Health Clinic/Center
  • Calumet, MI
  • NPI 1164106910
  NPD

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

• Aspirus Vna Home Health Inc.

  • Community Based Hospice Care Agency
  • Hancock, MI
  • NPI 1053546309
  Care Compare affiliation
• Aspirus Vna Home Health, Inc.

  • Home Health Agency
  • Hancock, MI
  • NPI 1578798401
  Care Compare affiliation
• Michigan in-Home Partner-III, LLC

  • Home Health Agency
  • Houghton, MI
  • NPI 1942749726
  Care Compare affiliation

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1346354461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "906-774-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 MARKET ST STE 9",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "49930",
            "telephone_number": "906-482-7762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 MacInnes Dr.",
            "address_purpose": "LOCATION",
            "city": "Houghton",
            "state": "MI",
            "postal_code": "49931",
            "country_code": "US",
            "telephone_number": "906-483-1860",
            "fax_number": "906-483-1866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISTON",
        "first_name": "AUDREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101012074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "0C16002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS STATE ID",
            "identifier": "AL012074",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114387160",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0829560001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Larson, MS, AT, ATC
• Tara Lynn Lassila, P.A.
• Leonard W. Beesley, DDS
• Ann Lepisto, RDH
• Zoe Michelle Lincoln, LPC
• William Liston, DO
• Dong Liu, MD
• Deborah R Lorenz
• Gina Maria Louis-Mercier, M.D.
• Kirk C Lufkin, MD

• Family Medicine Physician in Hancock, MI
• Providers in Hancock, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.