Michelle Doran, DO
Individual provider Active NPI Obstetrics & Gynecology Physician · Essexville, MI
NPI 1669600581 · NPPES record last updated Jan 10, 2018
Key facts
- NPI
- 1669600581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 5101018404 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- 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 Practices
Practice addresses (Care Compare)
42 N Saint Joseph Ave
Suite 201
Niles, MI 49120-2203
Phone (269) 687-0808
Hospital & facility affiliations
- Lakeland Hospital, St Joseph
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180123002753 | MI | Practitioner - Obstetrics/Gynecology | 8820357635 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101018404 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Immediate Care Center | Family Medicine | Current |
Accepting new patients |
| Lakeland Medical Practices | Current |
Accepting new patients | |
| Lakeland Immediate Care Center | Current |
Accepting new patients | |
| Lakeland Medical Practices | Current |
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
42 N Saint Joseph Ave
Ste 201
Niles, MI 49120
Phone (269) 429-5007
1951 Oak St
Niles, MI 49120
Phone (269) 262-4749
3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990
Interoperability endpoints
- mdoran1269192@epic00.corewelldirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101018404 | MI | |
| Obstetrics & Gynecology Physician | 207V00000X | 5101018404 | MI | Yes |
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
Other providers in Essexville, MI
- Heidi Ann Dahn
- Darrell M. Sheets, DMD PLC
- Jonathan A Dereszynski
- Merri Desanto
- DO-All, Inc.
- Serenity Louise Dycewicz
- Judi Ecker
- Ladora Sharrell Elliott
- John A Emond
- Euclid Medical Group P.C.
All providers in Essexville, MI · Obstetrics & Gynecology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.