Active NPI
Colleen June Essary, DO
- Family Medicine Physician
- Gaylord, MI
National Provider Identifier
1922290964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101008393
- Practice address
- 829 N Center Ave Ste 210
Gaylord, MI 49735-1599 - Phone
- (989) 731-7860
- NPI assigned
- Aug 14, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101008393 | MI | Primary |
Addresses
Primary practice location
829 N Center Ave Ste 210
Gaylord, MI 49735-1599
Mailing address
10359 Old Highway 54
New Bloomfield, MO 65063
Phone (573) 632-5582
Other names 1
- Colleen June Vellema
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244678400000",
"number": "1922290964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10359 OLD HIGHWAY 54",
"city": "NEW BLOOMFIELD",
"state": "MO",
"postal_code": "65063",
"telephone_number": "573-632-5582",
"fax_number": "573-632-5875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "829 N CENTER AVE STE 210",
"city": "GAYLORD",
"state": "MI",
"postal_code": "497351599",
"telephone_number": "989-731-7860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESSARY",
"first_name": "COLLEEN",
"middle_name": "JUNE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-14",
"last_updated": "2009-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101008393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COLLEEN",
"last_name": "VELLEMA",
"middle_name": "JUNE",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gaylord, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.