Active NPI
Daniel Robert Fermaglich, MD
- Pediatrics Physician
- Jackson, MI
National Provider Identifier
1407812464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301086739
- Practice address
- 110 N Elm Ave
Jackson, MI 49202-3571 - Phone
- (517) 788-6760
- Fax
- (517) 788-3029
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301086739 | MI | Primary |
Addresses
Primary practice location
110 N Elm Ave
Jackson, MI 49202-3571
Mailing address
PO Box 67000
Department 272801
Detroit, MI 48267-2728
Phone (517) 841-6913
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301086739 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wa Foote Memorial Hospital, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Henry Ford Allegiance Health
- Emergency Medicine Physician
- Jackson, MI
- NPI 1265487722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1407812464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 67000",
"address_2": "DEPARTMENT 272801",
"city": "DETROIT",
"state": "MI",
"postal_code": "482672728",
"telephone_number": "517-841-6913",
"fax_number": "517-841-6917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 N ELM AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492023571",
"telephone_number": "517-788-6760",
"fax_number": "517-788-3029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERMAGLICH",
"first_name": "DANIEL",
"middle_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301086739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.