NPIMap

Individual provider Active NPI

Michele L Raymond, D.O.

  • Family Medicine Physician
  • Port Huron, MI
National Provider Identifier
1689641557
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013489 Issued in MI
Practice address
2425 Military St
Building 2
Port Huron, MI 48060-6692
Phone
(810) 984-5700
Fax
(810) 984-1886
NPI assigned
Mar 1, 2006
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013489 MI Primary

Addresses

Primary practice location

2425 Military St
Building 2
Port Huron, MI 48060-6692

Mailing address

2425 Military St
Building 2
Port Huron, MI 48060-6692
Phone (810) 984-5700

Other identifiers 1

IdentifierTypeStateIssuer
1689641557MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000534 MI Practitioner - Family Practice 0345215745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Healthcare Network PCGroup PAC ID 3476456252, 30 clinicians

Practice addresses (Care Compare)

2425 Military St
BLDG 2
Port Huron, MI 48060-6692
Phone (810) 984-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Healthcare Network, PC CurrentSince Feb 24, 2022 Accepting new patients
Physician Healthcare Network, PC Family Medicine CurrentSince Aug 1, 2004 Accepting new patients
Physician Healthcare Network, PC Past Accepting new patients

Locations

3350 Gratiot Blvd
Marysville, MI 48040
Phone (810) 364-4000

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

2425 Military St
Bldg 2
Port Huron, MI 48060
Phone (810) 984-4194

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11357/brand/3/csg/1/fhir/r4
  • Direct secure messaging: michele.raymond.1@11357.direct.athenahealth.com

Organizations & group practices 3

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 6

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1689641557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 MILITARY ST",
            "address_2": "BUILDING 2",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606692",
            "telephone_number": "810-984-5700",
            "fax_number": "810-984-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 MILITARY ST",
            "address_2": "BUILDING 2",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606692",
            "telephone_number": "810-984-5700",
            "fax_number": "810-984-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "MICHELE",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689641557",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.