Individual provider Active NPI

David John Ahonen, FNP-BC

  • Nurse Practitioner
  • Iron Mountain, MI
National Provider Identifier
1447719794
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704272410 Issued in MI
Practice address
325 E H St
Iron Mountain, MI 49801-4760
Phone
(906) 774-3300
NPI assigned
Mar 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704272410 MI Primary

Addresses

Primary practice location

325 E H St
Iron Mountain, MI 49801-4760

Mailing address

325 E H St
Iron Mountain, MI 49801-4760
Phone (906) 774-3300

Other practice location 1

580 W College Ave
Marquette, MI 49855-2736
Phone (906) 225-4575

Other identifiers 1

IdentifierTypeStateIssuer
4704272410OtherMIRN NURSE PRACTITIONER SPECIALTY CERTIFICATION

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
I20190619001898 MI Practitioner - Nurse Practitioner 4587998950 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704272410MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince May 12, 2019 Accepting new patients
DLP Marquette Physician Practices Inc Nurse Practitioner CurrentSince May 12, 2019 Accepting new patients

Locations

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1447719794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "906-774-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "906-774-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 W College Ave",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498552736",
            "country_code": "US",
            "telephone_number": "906-225-4575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHONEN",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-17",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704272410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN NURSE PRACTITIONER SPECIALTY CERTIFICATION",
            "identifier": "4704272410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.