Individual provider Active NPI

Jilian Danitz, D.O.

  • Psychiatry Physician
  • Midland, MI
National Provider Identifier
1790992840
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101016376 Issued in MI
Practice address
218 Fast Ice Dr
Midland, MI 48642-6167
Phone
(989) 631-2320
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101016376 MI Primary

Addresses

Primary practice location

218 Fast Ice Dr
Midland, MI 48642-6167

Mailing address

218 Fast Ice Dr
Midland, MI 48642-6167
Phone (989) 631-2320

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
I20110210000876 MI Practitioner - Psychiatry 5698955458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Mental Health for Central MichiganGroup PAC ID 4688660533, 44 clinicians

Practice addresses (Care Compare)

218 Fast Ice Dr
Midland, MI 48642-6167
Phone (989) 631-2320

301 S Crapo St
Mt Pleasant, MI 48858-2941
Phone (989) 772-5938

655 E Cedar Ave
CMH for Central Michigan
Gladwin, MI 48624-2215
Phone (989) 426-9295

789 N Clare Ave
CMH for Central Michigan
Harrison, MI 48625-8250
Phone (989) 539-2141

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Psychiatry CurrentSince Nov 10, 2010 Accepting new patients
Community Mental Health for Central Michigan Psychiatry PastSince Nov 24, 2019 Accepting new patients

Locations

218 Fast Ice Dr
Midland, MI 48642
Phone (989) 631-2320

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

301 S Crapo St
Ste 100
Mt Pleasant, MI 48858
Phone (989) 772-5938

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1790992840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426167",
            "telephone_number": "989-631-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426167",
            "telephone_number": "989-631-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANITZ",
        "first_name": "JILIAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101016376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.