Active NPI
Alison Mackenzie Emmitt, M.D.
- Pediatrics Physician
- Ypsilanti, MI
National Provider Identifier
1467987164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301501200
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191002003115 | NY | Order and Referring Only - Pediatric Medicine | 7113257262 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301501200 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.