Individual provider Active NPI

Ronnie Ray Sorrow Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Jackson, MI
National Provider Identifier
1962659680
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
1979516 Issued in MI
Practice address
683 Robinson Rd
Jackson, MI 49203-1155
Phone
(517) 787-0417
Fax
(517) 787-5536
NPI assigned
Aug 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 1979516 MI Primary

Addresses

Primary practice location

683 Robinson Rd
Jackson, MI 49203-1155

Mailing address

683 Robinson Rd
Jackson, MI 49203-1155
Phone (517) 787-0417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022001229 MI Practitioner - Oral Surgery 1658564596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
University of Tennessee, HSC, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardon and Sorrow Oral and Maxillofacial Surgery PLCGroup PAC ID 5799922712, 2 clinicians

Practice addresses (Care Compare)

683 Robinson Rd
Jackson, MI 49203-1155
Phone (517) 787-0417

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1979516MIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Cardon & Sorrow Oral and Maxillofacial Surgery PLC Oral and Maxillofacial Surgery CurrentSince Mar 24, 2015 Accepting new patients

Locations

683 Robinson Rd
Jackson, MI 49203
Phone (517) 787-0417

Interoperability endpoints

  • Direct secure messaging: rsorrow462895@direct.hfhs.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1962659680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 ROBINSON RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031155",
            "telephone_number": "517-787-0417",
            "fax_number": "517-787-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 ROBINSON RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031155",
            "telephone_number": "517-787-0417",
            "fax_number": "517-787-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORROW",
        "first_name": "RONNIE",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "1979516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.