Individual provider Active NPI

John D Talbott, DO

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Petoskey, MI
National Provider Identifier
1942309455
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
5101010171 Issued in MI
Practice address
560 W Mitchell St Ste 400
MHVS Cardiovascular & Thoracic Surger
Petoskey, MI 49770-2274
Phone
(231) 487-4950
Fax
(231) 487-4951
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 5101010171 MI Primary

Addresses

Primary practice location

560 W Mitchell St Ste 400
MHVS Cardiovascular & Thoracic Surger
Petoskey, MI 49770-2274

Mailing address

416 Connable
Petoskey, MI 49770
Phone (231) 487-7129

Other identifiers 2

IdentifierTypeStateIssuer
4853893MedicaidMI
533089OtherMIBCBS INDIVIDUAL PIN

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1942309455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 CONNABLE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-487-7129",
            "fax_number": "231-487-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST STE 400",
            "address_2": "MHVS CARDIOVASCULAR & THORACIC SURGER",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702274",
            "telephone_number": "231-487-4950",
            "fax_number": "231-487-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOTT",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "5101010171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4853893",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "533089",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.