Individual provider Active NPI

Alison Mackenzie Emmitt, M.D.

  • Pediatrics Physician
  • Ypsilanti, MI
National Provider Identifier
1467987164
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301501200 Issued in MI
Practice address
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone
(734) 712-3325
Fax
(734) 712-5525
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 4301501200 MI Primary

Addresses

Primary practice location

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Mailing address

24 Frank Lloyd Wright Dr Ste J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other practice location 1

601 Elmwood Ave
Box 777R
Rochester, NY 14642-0001
Phone (585) 275-6918

Other names 1

  • Miss Alison Paige Mackenzie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20191002003115 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7113257262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301501200MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital 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.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1467987164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3325",
            "fax_number": "734-712-5525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_2": "Box 777R",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-6918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMITT",
        "first_name": "ALISON",
        "middle_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301501200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISON",
            "last_name": "MACKENZIE",
            "middle_name": "PAIGE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.