Active NPI
William Eugene Jarvis, DPM
- Podiatrist
- Clinton Township, MI
National Provider Identifier
1861508830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- WJ000714
- Practice address
- 36325 Harper Ave
Clinton Township, MI 48035-2958 - Phone
- (586) 791-2900
- NPI assigned
- Aug 22, 2006
- Last updated
- Mar 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | WJ000714 | MI | Primary |
Addresses
Primary practice location
36325 Harper Ave
Clinton Township, MI 48035-2958
Mailing address
36325 Harper Ave
Clinton Township, MI 48035-2958
Phone (586) 791-2900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1092464 | Medicaid | MI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WJ000714 | MI | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425254400000",
"number": "1861508830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36325 HARPER AVE",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480352958",
"telephone_number": "586-791-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36325 HARPER AVE",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480352958",
"telephone_number": "586-791-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIS",
"first_name": "WILLIAM",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2015-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "WJ000714",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1092464",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.