Active NPI
John S Munn, M.D.
- Vascular Surgery Physician
- Kalamazoo, MI
National Provider Identifier
1700841459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 4301056681
- Practice address
- 1815 Henson Ave
Kalamazoo, MI 49048-1510 - Phone
- (269) 492-6500
- Fax
- (269) 492-6461
- NPI assigned
- Apr 18, 2006
- Last updated
- Apr 12, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 4301056681 | MI | Primary |
Addresses
Primary practice location
1815 Henson Ave
Kalamazoo, MI 49048-1510
Mailing address
1815 Henson Ave
Kalamazoo, MI 49048-1510
Phone (269) 492-6500
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4048846 | Other | MI | AETNA |
| 1417961137 | Other | MI | BCBSM - BMH |
| 1700841459 | Medicaid | MI | |
| P53176 | Other | MI | BLUE CARE NETWORK |
| 3416614-10 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301056681 | MI | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1700841459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 HENSON AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490481510",
"telephone_number": "269-492-6500",
"fax_number": "269-492-6461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 HENSON AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490481510",
"telephone_number": "269-492-6500",
"fax_number": "269-492-6461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNN",
"first_name": "JOHN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MI",
"license": "4301056681",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4048846",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM - BMH",
"identifier": "1417961137",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700841459",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "P53176",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3416614-10",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.