Active NPI
Ronald Max Mingle, PAC
- Physician Assistant
- Mt Pleasant, MI
National Provider Identifier
1881772861
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jan 19, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601001143
- Practice address
- 1621 E Broomfield St
Suite B
Mt Pleasant, MI 48858-5427 - Phone
- (989) 772-1442
- Fax
- (989) 772-0735
- NPI assigned
- Nov 1, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601001143 | MI | Primary |
Addresses
Primary practice location
1621 E Broomfield St
Suite B
Mt Pleasant, MI 48858-5427
Mailing address
PO Box 994
Alma, MI 48801-0994
Phone (989) 463-0104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0853713260 | Other | MI | BCBSM |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601001143 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251158400000",
"number": "1881772861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 994",
"city": "ALMA",
"state": "MI",
"postal_code": "488010994",
"telephone_number": "989-463-0104",
"fax_number": "989-463-0663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 E BROOMFIELD ST",
"address_2": "SUITE B",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488585427",
"telephone_number": "989-772-1442",
"fax_number": "989-772-0735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINGLE",
"first_name": "RONALD",
"middle_name": "MAX",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2009-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601001143",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "0853713260",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.