Individual provider Active NPI

James B Mitton, D.O.

  • Family Medicine Physician
  • Jenison, MI
National Provider Identifier
1922062108
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101006317 Issued in MI
Practice address
7686 Georgetown Center Dr
Jenison, MI 49428-8101
Phone
(616) 252-4765
Fax
(616) 252-0127
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101006317 MI Primary

Addresses

Primary practice location

7686 Georgetown Center Dr
Jenison, MI 49428-8101

Mailing address

1925 Breton Rd SE
Grand Rapids, MI 49506-4810
Phone (616) 252-4765

Other identifiers 1

IdentifierTypeStateIssuer
3452568MedicaidMI

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101006317MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Past Accepting new patients

Organizations & group practices 1

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922062108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 BRETON RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064810",
            "telephone_number": "616-252-4765",
            "fax_number": "616-252-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7686 GEORGETOWN CENTER DR",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288101",
            "telephone_number": "616-252-4765",
            "fax_number": "616-252-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTON",
        "first_name": "JAMES",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101006317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3452568",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.