Anne Dudley, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101018463 Issued in MI

Practice address

5515 Cleveland Ave
Stevensville, MI 49127-9670

Phone

(269) 429-6604

Fax

(269) 429-1715

NPI assigned

Jul 2, 2009

Last updated

Feb 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adudley1269235@epic00.corewelldirect.org
• Direct secure messaging: adudley14542@lakeland.midirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1588893283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-6604",
            "fax_number": "269-429-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-6604",
            "fax_number": "269-429-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "ANNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101018463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588893283",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "address_1": "5515 Cleveland Ave",
            "city": "Stevensville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "491279670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Phil Joseph Demeulenaere III, RPH
• Dawn R Diggs, LPC
• Elizabeth RL Douce, MD
• Dr Melanie J Jones Optometrist PC
• Dr. William K. Wooten, D.C. P.C.
• Denise G Durak, PSYD
• Joel David Duran, PT, DPT
• Krista Hansen Elkins, LLPC
• Brian Facione, D.O.
• Mary Frank, PSYCHOLOGIST

• Pediatrics Physician in Stevensville, MI
• Providers in Stevensville, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.

Verify at the official NPI Registry.