Individual provider Active NPI

James E Dewitt, DPM

  • Primary Podiatric Medicine Podiatrist
  • Wyoming, MI
National Provider Identifier
1659309060
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
JD001490 Issued in MI
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, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
P65453OtherMIBLUE CARE NETWORK
2870966MedicaidMI
5415013OtherMIBLUE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000339 MI Practitioner - Podiatry 2567562382 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
JD001490MIMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Mobile Podiatry, PLLC CurrentSince Apr 23, 2024 Accepting new patients
Advanced Foot and Ankle Associates, PC Primary Podiatric Medicine CurrentSince May 15, 1995 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.

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

Verify at the official NPI Registry.