Active NPI
Mark E Hatch, D.O.
- Dermatology Physician
- Lansing, MI
National Provider Identifier
1447289285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MH008596
- Practice address
- 416 S Creyts Rd
Lansing, MI 48917-8290 - Phone
- (517) 886-0333
- Fax
- (517) 886-2072
- NPI assigned
- Jul 2, 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MH008596 | MI | Primary |
Addresses
Primary practice location
416 S Creyts Rd
Lansing, MI 48917-8290
Mailing address
416 S Creyts Rd
Lansing, MI 48917-8290
Phone (517) 886-0333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1592069 | Medicaid | MI |
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH008596 | MI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203984000000",
"number": "1447289285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 S CREYTS RD",
"city": "LANSING",
"state": "MI",
"postal_code": "489178290",
"telephone_number": "517-886-0333",
"fax_number": "517-886-2072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 S CREYTS RD",
"city": "LANSING",
"state": "MI",
"postal_code": "489178290",
"telephone_number": "517-886-0333",
"fax_number": "517-886-2072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATCH",
"first_name": "MARK",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-02",
"last_updated": "2008-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "MH008596",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1592069",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.