Individual provider Active NPI

Audrey Rose Eakman, MD

  • Student in an Organized Health Care Education/Training Program
  • Chelsea, MI
National Provider Identifier
1720922602
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351055618 Issued in MI
Practice address
14700 E Old US Highway 12
Chelsea, MI 48118-1185
Phone
(505) 916-9335
NPI assigned
Apr 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351055618 MI Primary

Addresses

Primary practice location

14700 E Old US Highway 12
Chelsea, MI 48118-1185

Mailing address

300 N Ingalls St # Ni4C06
Ann Arbor, MI 48109-0400
Phone (734) 475-1321

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
I20260505003026 MI Order and Referring Only - Family PracticePractitioner - Family Practice 5294203584

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351055618MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1720922602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N INGALLS ST # NI4C06",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481090400",
            "telephone_number": "734-475-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 E OLD US HIGHWAY 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181185",
            "telephone_number": "505-916-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKMAN",
        "first_name": "AUDREY",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351055618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.