Individual provider Active NPI

Michelle Doran, DO

  • Obstetrics & Gynecology Physician
  • Essexville, MI
National Provider Identifier
1669600581
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101018404 Issued in MI
Practice address
1458 W Center Rd
Suite 1
Essexville, MI 48732-2151
Phone
(989) 895-4625
Fax
(989) 895-4626
NPI assigned
Jun 30, 2009
Last updated
Jan 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101018404 MI
Obstetrics & Gynecology Physician 207V00000X 5101018404 MI Primary

Addresses

Primary practice location

1458 W Center Rd
Suite 1
Essexville, MI 48732-2151

Mailing address

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-1000

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180123002753 MI Practitioner - Obstetrics/Gynecology 8820357635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

42 N Saint Joseph Ave
Suite 201
Niles, MI 49120-2203
Phone (269) 687-0808

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5101018404MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Dec 24, 2019 Accepting new patients
Lakeland Medical Practices CurrentSince Dec 24, 2019 Accepting new patients
Lakeland Immediate Care Center CurrentSince Jul 1, 2022 Accepting new patients
Lakeland Immediate Care Center Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Past Accepting new patients

Locations

261 M 62
Cassopolis, MI 49031
Phone (269) 445-3874

1951 Oak St
Niles, MI 49120
Phone (269) 262-4749

42 N Saint Joseph Ave
Ste 201
Niles, MI 49120
Phone (269) 429-5007

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: mdoran1269192@epic00.corewelldirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1669600581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "810-342-1000",
            "fax_number": "810-342-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 W CENTER RD",
            "address_2": "SUITE 1",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487322151",
            "telephone_number": "989-895-4625",
            "fax_number": "989-895-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101018404",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101018404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essexville, MI

Sources for this page

Verify at the official NPI Registry.