Individual provider Active NPI

Julie Creighton Sovis, DO

  • Pediatrics Physician
  • Owosso, MI
National Provider Identifier
1912311853
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101021125 Issued in MI
Practice address
802 W King St Ste M
Owosso, MI 48867-2100
Phone
(989) 729-4100
Fax
(989) 729-4066
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101021125 MI Primary

Addresses

Primary practice location

802 W King St Ste M
Owosso, MI 48867-2100

Mailing address

802 W King St Ste M
Owosso, MI 48867-2100
Phone (989) 729-4100

Other identifiers 2

IdentifierTypeStateIssuer
1912311853MedicaidMI
5101021125OtherMIMEDICAL LICENSE NUMBER

Other names 1

  • Julie Creighton Former name

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
I20170714001976 MI Practitioner - Pediatric Medicine 9234409806 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101021125MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Pediatrics CurrentSince Sep 5, 2017 Accepting new patients
Memorial Hospital Current Accepting new patients
Memorial Hospital CurrentSince Sep 5, 2017 Accepting new patients
Memorial Hospital Past Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

1975 W M 21
Ste 103
Owosso, MI 48867

802 W King St
Ste C
Owosso, MI 48867
Phone (989) 729-4131

802 W King St
Ste M
Owosso, MI 48867
Phone (989) 725-9846

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

Interoperability endpoints

  • Direct secure messaging: juliecreighton@memh.allscriptsdirect.net
  • Direct secure messaging: j.creighton@memorialhealthcare.midirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1912311853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 W KING ST STE M",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672100",
            "telephone_number": "989-729-4100",
            "fax_number": "989-729-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W KING ST STE M",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672100",
            "telephone_number": "989-729-4100",
            "fax_number": "989-729-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOVIS",
        "first_name": "JULIE",
        "middle_name": "CREIGHTON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101021125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912311853",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "5101021125",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "CREIGHTON",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.