Individual provider Active NPI

Dennis M Joy, M.D.

  • Family Medicine Physician
  • Charlevoix, MI
National Provider Identifier
1922090547
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DJ033990 Issued in MI
Practice address
14705 W Upright St
Charlevoix, MI 49720-1949
Phone
(231) 547-1308
Fax
(231) 392-7332
NPI assigned
Aug 19, 2005
Last updated
May 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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 DJ033990 MI Primary

Addresses

Primary practice location

14705 W Upright St
Charlevoix, MI 49720-1949

Mailing address

14705 W Upright St
Charlevoix, MI 49720-1949
Phone (231) 547-1308

Other identifiers 1

IdentifierTypeStateIssuer
2813084MedicaidMI

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 Medicine

State licenses

LicenseStateTypeSpecialty
DJ033990MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark W Smith MD PLC LLC Family Medicine PastSince May 9, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1922090547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14705 W UPRIGHT ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201949",
            "telephone_number": "231-547-1308",
            "fax_number": "231-392-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14705 W UPRIGHT ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201949",
            "telephone_number": "231-547-1308",
            "fax_number": "231-392-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOY",
        "first_name": "DENNIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DJ033990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2813084",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.