Individual provider Active NPI

Colton Funkhouser, MD

  • Dermatology Physician
  • Ann Arbor, MI
National Provider Identifier
1407481898
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301513700 Issued in MI
Practice address
4200 Whitehall Dr Ste 250
Ann Arbor, MI 48105-9694
Phone
(734) 677-3376
Fax
(734) 572-3229
NPI assigned
Mar 6, 2020
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4301513700 MI Primary

Addresses

Primary practice location

4200 Whitehall Dr Ste 250
Ann Arbor, MI 48105-9694

Mailing address

4200 Whitehall Dr Ste 250
Ann Arbor, MI 48105-9694
Phone (734) 677-3376

Other practice location 1

2305 Genoa Business Park Dr Ste 180
Brighton, MI 48114-7007
Phone (810) 355-4300

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717001623 MI Practitioner - Dermatology 5597156117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Georgetown University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Phototherapy Center of Brighton PLCGroup PAC ID 7618114695, 9 clinicians
Dermatology Specialists of Ann Arbor PLLCGroup PAC ID 9830574672, 10 clinicians

Practice addresses (Care Compare)

2305 Genoa Business Park Dr
Suite 180
Brighton, MI 48114-7007
Phone (810) 355-4300

4200 Whitehall Dr
Suite 250
Ann Arbor, MI 48105-9694
Phone (734) 677-3376

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions91
Removal or shaving of skin growth1-10
Skin biopsy50

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology & Phototherapy Center of Brighton, PLC Dermatology CurrentSince Aug 1, 2025 Accepting new patients
Dermatology Specialists of Ann Arbor, PLLC Dermatology CurrentSince Aug 1, 2025 Accepting new patients

Locations

4200 Whitehall Dr
Ste 250
Ann Arbor, MI 48105
Phone (734) 622-5016

2305 Genoa Business Park Dr
Ste 180
Brighton, MI 48114
Phone (810) 227-3232

43151 Dalcoma Dr
Clinton Twp, MI 48038
Phone 5862868720308

43151 Dalcoma Dr
Ste 6
Clinton Twp, MI 48038

Organizations & group practices 2

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 2

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": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1407481898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 WHITEHALL DR STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059694",
            "telephone_number": "734-677-3376",
            "fax_number": "734-572-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WHITEHALL DR STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059694",
            "telephone_number": "734-677-3376",
            "fax_number": "734-572-3229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 Genoa Business Park Dr Ste 180",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481147007",
            "country_code": "US",
            "telephone_number": "810-355-4300",
            "fax_number": "810-355-4967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNKHOUSER",
        "first_name": "COLTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-06",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301513700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.