Individual provider Active NPI

Jaak Mart Pahn, M.D.

  • Family Medicine Physician
  • Sault Sainte Marie, MI
National Provider Identifier
1720026735
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
JP043613 Issued in MI
Practice address
550 Osborn Blvd
Suite 101
Sault Sainte Marie, MI 49783-1899
Phone
(906) 632-0370
Fax
(906) 632-2081
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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 JP043613 MI Primary

Addresses

Primary practice location

550 Osborn Blvd
Suite 101
Sault Sainte Marie, MI 49783-1899

Mailing address

550 Osborn Blvd
Suite 101
Sault Sainte Marie, MI 49783-1899
Phone (906) 632-0370

Other identifiers 1

IdentifierTypeStateIssuer
4667593MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JP043613MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1720026735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 OSBORN BLVD",
            "address_2": "SUITE 101",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831899",
            "telephone_number": "906-632-0370",
            "fax_number": "906-632-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 OSBORN BLVD",
            "address_2": "SUITE 101",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831899",
            "telephone_number": "906-632-0370",
            "fax_number": "906-632-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAHN",
        "first_name": "JAAK",
        "middle_name": "MART",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JP043613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4667593",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.