Individual provider Active NPI

Aaron T Misner, NP

  • General Practice Physician
  • Port Huron, MI
National Provider Identifier
1356812697
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4704286735 Issued in MI
Practice address
2601 Electric Ave
Port Huron, MI 48060-6587
Phone
(810) 216-1500
NPI assigned
Dec 16, 2018
Last updated
Dec 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4704286735 MI Primary

Addresses

Primary practice location

2601 Electric Ave
Port Huron, MI 48060-6587

Mailing address

22419 Milner St
Saint Clair Shores, MI 48081-2078
Phone (586) 876-2122

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191031001388 MI Practitioner - Nurse Practitioner 6406188093 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704286735MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services-Port Huron LLC CurrentSince Aug 31, 2019 Accepting new patients
East Michigan Hospitalists PLLC CurrentSince Nov 1, 2019 Accepting new patients
Prime Healthcare Services-Port Huron LLC CurrentSince Aug 31, 2019 Accepting new patients
Prime Healthcare Services-Port Huron LLC Past Accepting new patients

Locations

1217 Kearney St
Ste 2
Port Huron, MI 48060
Phone (810) 990-8302

2601 Electric Ave
Port Huron, MI 48060
Phone (810) 216-1500

2601 Electric Ave
#C
Port Huron, MI 48060
Phone (810) 216-1500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1356812697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22419 MILNER ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812078",
            "telephone_number": "586-876-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606587",
            "telephone_number": "810-216-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISNER",
        "first_name": "AARON",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4704286735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.