Individual provider Active NPI

George E Overly, MD

  • Family Medicine Physician
  • Norton Shores, MI
National Provider Identifier
1962403709
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301052054 Issued in MI
Practice address
800 E Ellis Rd
Norton Shores, MI 49441-5622
Phone
(231) 798-9840
Fax
(231) 798-9740
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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 4301052054 MI Primary

Addresses

Primary practice location

800 E Ellis Rd
Norton Shores, MI 49441-5622

Mailing address

800 E Ellis Rd
Norton Shores, MI 49441-5622
Phone (231) 798-9840

Other identifiers 1

IdentifierTypeStateIssuer
7000006801MedicaidMA

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Muskegon PC Past Accepting new patients
Mercy Urgent Care Family Medicine Past Accepting new patients

Organizations & group practices 2

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1962403709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E ELLIS RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494415622",
            "telephone_number": "231-798-9840",
            "fax_number": "231-798-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E ELLIS RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494415622",
            "telephone_number": "231-798-9840",
            "fax_number": "231-798-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERLY",
        "first_name": "GEORGE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301052054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000006801",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.