Mitzi Colleen Amelon, D.O.
Individual provider Active NPI Family Medicine Physician · Gwinn, MI
NPI 1831140409 · NPPES record last updated Oct 29, 2024
Key facts
- NPI
- 1831140409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101010674 (MI)
- Practice address
- 135 E M35
Gwinn, MI 49841-9160 - Phone
- (906) 346-9275
- Fax
- (906) 372-3230
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Upper Great Lakes Family Health Center
Practice addresses (Care Compare)
135 E
Gwinn, MI 49841-9160
Phone (906) 346-9275
Hospital & facility affiliations
- Uphs Marquette DLP Hospital
- Trinity Health Ann Arbor Hospital
- Huron Valley-Sinai Hospital
- Trinity Health Livingston Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230124000377 | AL | Practitioner - Family Practice | 8325029663 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2958 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Great Lakes Family Health Center | Current |
Accepting new patients | |
| Houston County Healthcare Authority | Family Medicine | Current | Accepting new patients |
| Medcore Associates, PLLC | Current | Accepting new patients | |
| Upper Great Lakes Family Health Center | Current |
Accepting new patients | |
| Upper Great Lakes Family Health Center | Family Medicine | Current | Accepting new patients |
| Pathology Laboratory Associates | Current | Accepting new patients | |
| Houston County Healthcare Authority | Family Medicine | Current |
Accepting new patients |
| Houston County Healthcare Authority | Current | Accepting new patients | |
| State of Michigan Office of Financial Management | Past |
Accepting new patients | |
| Upper Great Lakes Family Health Center | Family Medicine | Past | Accepting new patients |
Locations
415 Midland St
Ashford, AL 36312
Phone (334) 899-3363
1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635
301 Explorer St
Gwinn, MI 49841
Phone (906) 346-4924
135 E State Highway M35
Gwinn, MI 49841
Phone (906) 346-9275
500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101010674 | MI | Yes |
Addresses
Primary practice location
135 E M35
Gwinn, MI 49841-9160
Mailing address
301 Explorer St
Gwinn, MI 49841-2813
Phone (906) 481-8586
Other providers in Gwinn, MI
- Leah Abbott
- Zackery Robert Acton
- Mabel A Adams
- Christie Kathlene Alderton
- Stacey Andresen
- Barabe Home
- Lynn M Barry
- Mark William Breit
- Ashley Jean Brintlinger
All providers in Gwinn, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.