Individual provider Active NPI

Richard L Hartwell, DO

  • Emergency Medicine Physician
  • Traverse City, MI
National Provider Identifier
1790874105
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101008417 Issued in MI
Practice address
550 Munson Ave
Traverse City, MI 49686-3580
Phone
(231) 935-8685
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101008417 MI Primary

Addresses

Primary practice location

550 Munson Ave
Traverse City, MI 49686-3580

Mailing address

550 Munson Ave
Traverse City, MI 49686-3580
Phone (231) 935-8685

Other identifiers 1

IdentifierTypeStateIssuer
3128996MedicaidMI

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 Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790874105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863580",
            "telephone_number": "231-935-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863580",
            "telephone_number": "231-935-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWELL",
        "first_name": "RICHARD",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101008417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3128996",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.