Individual provider Active NPI

Dawn Nulf, MD

  • Emergency Medicine Physician
  • Hancock, MI
National Provider Identifier
1477566636
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301068353 Issued in MI
Practice address
500 Campus Dr
Hancock, MI 49930-1569
Phone
(906) 483-1000
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301068353 MI Primary

Addresses

Primary practice location

500 Campus Dr
Hancock, MI 49930-1569

Mailing address

500 Campus Dr
Hancock, MI 49930-1569
Phone (906) 483-1000

Other identifiers 5

IdentifierTypeStateIssuer
080165283OtherMIMEDICARE RAILROAD
0C16002OtherMIMEDICARE GROUP
104240954MedicaidMI
DN068353OtherMIBLUECROSS STATE ID
0829560001OtherMIMEDICARE DME

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
I20100130000108 MI Practitioner - Emergency Medicine 0143363192 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Portage Hospital LLC CurrentSince Feb 22, 2015 Accepting new patients
Baraga County Memorial Hospital Emergency Medicine CurrentSince Aug 23, 2019 Accepting new patients
Baraga County Memorial Hospital CurrentSince Aug 23, 2019 Accepting new patients
Portage Physician Practices Inc CurrentSince Dec 1, 2013 Accepting new patients
Portage Physician Practices Inc Emergency Medicine CurrentSince Dec 1, 2013 Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Portage Hospital LLC CurrentSince Feb 22, 2015 Accepting new patients
Portage Health Inc. Past Accepting new patients

Locations

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

894 Campus Dr
Ste B
Hancock, MI 49930
Phone (906) 483-1128

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

600 Macinnes Dr
Houghton, MI 49931
Phone (906) 483-1818

18341 US Highway 41
Lanse, MI 49946
Phone (906) 524-3300

Organizations & group practices 9

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1477566636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULF",
        "first_name": "DAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301068353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080165283",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "0C16002",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104240954",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS STATE ID",
            "identifier": "DN068353",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0829560001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.