Individual provider Active NPI

Jude L Stratford, D.O.

  • Family Medicine Physician
  • Fort Gratiot, MI
National Provider Identifier
1437125473
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101012723 Issued in MI
Practice address
3903 Stoney Ridge Dr
Fort Gratiot, MI 48059-3761
Phone
(810) 385-2295
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101012723 MI Primary
Family Medicine Physician 207Q00000X 50712 CO

Addresses

Primary practice location

3903 Stoney Ridge Dr
Fort Gratiot, MI 48059-3761

Mailing address

3903 Stoney Ridge Dr
Fort Gratiot, MI 48059-3761
Phone (810) 385-2295

Other identifiers 1

IdentifierTypeStateIssuer
1437125473MedicaidMI

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
I20091222000220 MI Practitioner - Family Practice 6103966205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Macomb Medical Associates PLLCGroup PAC ID 0648175133, 4 clinicians

Practice addresses (Care Compare)

66440 Gratiot Ave
Lenox, MI 48050-2032
Phone (586) 727-5840

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50712COMDFamily Medicine Physician
5101012723MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Healthcare Network, PC Family Medicine Current Accepting new patients
North Macomb Medical Associates PLLC Family Medicine CurrentSince May 1, 2015 Accepting new patients
First Choice Urgent Care PC Past Accepting new patients

Locations

66440 Gratiot Ave
#A
Lenox, MI 48050

66440 Gratiot Ave
Lenox, MI 48050
Phone (586) 430-4022

3350 Gratiot Blvd
Marysville, MI 48040
Phone (810) 364-4000

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1437125473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 STONEY RIDGE DR",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593761",
            "telephone_number": "810-385-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 STONEY RIDGE DR",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593761",
            "telephone_number": "810-385-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRATFORD",
        "first_name": "JUDE",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101012723",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "50712",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437125473",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

Verify at the official NPI Registry.