Active NPI
Marybeth Hines, DO
- Emergency Medicine Physician
- Hancock, MI
National Provider Identifier
1497704480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MI51010262
- Practice address
- 500 Campus Dr
Hancock, MI 49930-1569 - Phone
- (906) 483-1000
- Fax
- (906) 483-1103
- NPI assigned
- May 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MI51010262 | 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 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0829560001 | Other | MI | MEDICARE DME |
| 0C16002 | Other | MI | MEDICARE GROUP |
| MH010262 | Other | MI | BLUECROSS STATE ID |
| 114509440 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MI51010262 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portage Health Inc. | 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.
-
- Family Medicine Physician
- Hancock, MI
- NPI 1821128968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260144000000",
"number": "1497704480",
"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",
"fax_number": "906-483-1103"
},
{
"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",
"fax_number": "906-483-1103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "MARYBETH",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-08",
"last_updated": "2009-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "MI51010262",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DME",
"identifier": "0829560001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "0C16002",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS STATE ID",
"identifier": "MH010262",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114509440",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hancock, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.