Active NPI
James E Dewitt, DPM
- Primary Podiatric Medicine Podiatrist
- Wyoming, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- JD001490
- Practice address
- 1621 44TH St SW Ste 500
Wyoming, MI 49509-7200 - Phone
- (616) 538-4442
- Fax
- (616) 538-4843
- NPI assigned
- Jun 28, 2006
- Last updated
- Jan 13, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | JD001490 | MI | Primary |
| Foot Surgery Podiatrist | 213ES0131X | JD001490 | MI |
Addresses
Primary practice location
1621 44TH St SW Ste 500
Wyoming, MI 49509-7200
Mailing address
1621 44TH St SW Ste 500
Wyoming, MI 49509-7200
Phone (616) 538-4442
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P65453 | Other | MI | BLUE CARE NETWORK |
| 2870966 | Medicaid | MI | |
| 5415013 | Other | MI | BLUE SHIELD PROVIDER |
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JD001490 | MI | MD | Primary Podiatric Medicine Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Mobile Podiatry, PLLC | Current | Accepting new patients | |
| Advanced Foot and Ankle Associates, PC | Primary Podiatric Medicine | Current | Accepting new patients |
Locations
30150 Telegraph Rd
Ste 371
Bingham Farms, MI 48025
Phone (734) 493-1662
1621 44th St SW
Ste 500
Wyoming, MI 49509
Phone (616) 538-4442
Organizations & group practices 2
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.
-
dba Advanced Foot Ankle and Wound
- Podiatrist
- Wyoming, MI
- NPI 1689729329
Primary Podiatric Medicine
-
- Podiatrist
- Southfield, MI
- NPI 1013347244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1659309060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 44TH ST SW STE 500",
"city": "WYOMING",
"state": "MI",
"postal_code": "495097200",
"telephone_number": "616-538-4442",
"fax_number": "616-538-4843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 44TH ST SW STE 500",
"city": "WYOMING",
"state": "MI",
"postal_code": "495097200",
"telephone_number": "616-538-4442",
"fax_number": "616-538-4843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWITT",
"first_name": "JAMES",
"middle_name": "E",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "MI",
"license": "JD001490",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "MI",
"license": "JD001490",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "P65453",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2870966",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER",
"identifier": "5415013",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.