Active NPI
Patricia Elaine McIntosh, FNP
- Family Nurse Practitioner
- Traverse City, MI
National Provider Identifier
1609985977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704076658
- Practice address
- 10767 E Traverse Hwy
Traverse City, MI 49684-6219 - Phone
- (261) 947-1112
- Fax
- (231) 947-7739
- NPI assigned
- Aug 30, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704076658 | MI | Primary |
Addresses
Primary practice location
10767 E Traverse Hwy
Traverse City, MI 49684-6219
Mailing address
10767 E Traverse Hwy
Traverse City, MI 49684-6219
Phone (261) 947-1112
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3462994 | Medicaid | MI | |
| 500866378 | Other | MI | BCBS |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704076658 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Michigan | 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.
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1609985977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10767 E TRAVERSE HWY",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496846219",
"telephone_number": "261-947-1112",
"fax_number": "231-947-7739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10767 E TRAVERSE HWY",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496846219",
"telephone_number": "261-947-1112",
"fax_number": "231-947-7739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTOSH",
"first_name": "PATRICIA",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704076658",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3462994",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "500866378",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.