Katherine J Ducharme, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004914 Issued in MN

Practice address

419 W State St
Mancelona, MI 49659

Phone

(231) 587-9181

Fax

(231) 587-0923

NPI assigned

Nov 19, 2008

Last updated

Jun 15, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ms_kduchar1@landmarkhealth-direct.org

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

• Mancelona Family Practice

  • Family Medicine Physician
  • Mancelona, MI
  • NPI 1780157081
  NPD (past)
• Mancelona Family Practice

  • Family Medicine Physician
  • Mancelona, MI
  • NPI 1891809349
  NPD (past)

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1831344779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "city": "MANCELONA",
            "state": "MI",
            "postal_code": "496590769",
            "telephone_number": "231-587-9181",
            "fax_number": "231-587-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 W STATE ST",
            "city": "MANCELONA",
            "state": "MI",
            "postal_code": "49659",
            "telephone_number": "231-587-9181",
            "fax_number": "231-587-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCHARME",
        "first_name": "KATHERINE",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "5601004914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Cannon
• Cedar Run Family Medicine Center
• Cassie A. Craft
• Cortney Crocker, CPNP-PC
• Amanda Marie Desjardins, DDS
• Richelle Dugyon
• Family Fare, LLC (Family Fare Pharmacy 1507)
• Kenedy Fomenko, D.M.D
• Patricia Lynn Fuller
• Given Hope Home Health Services (Given Hope LLC)

• Physician Assistant in Mancelona, MI
• Providers in Mancelona, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.