Provider Type Icon

DR. MARY ANNE PURTILL M.D. NPI 1831192483


NPI Information

NPI: 1831192483
Provider Name: DR. MARY ANNE PURTILL, M.D.
Classification: Surgery - 2086S0127X
Entity Type: Individual

Specialization: Trauma Surgery

PECOS Registration: Yes

Address:
1100 E MICHIGAN AVE
STE 201
JACKSON, MI
ZIP 49201
Phone: (517) 817-7605
Get Directions

DR. Mary Anne Purtill, M.D. is a trauma surgery surgery in Jackson, MI with 33 years of experience. The provider is trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. DR. Mary Anne Purtill, M.D. NPI is 1831192483. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduation Year:1991

The provider's business location address is:

1100 E MICHIGAN AVE
STE 201
JACKSON, MI
ZIP 49201-847
Phone: (517) 817-7605
Fax: (517) 817-7606

The NPI 1831192483 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/27/2005 and was last updated on 3/14/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryG076836CALIFORNIANo
22086S0127XSurgeryTrauma Surgery4301075397MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ZZZP4310ZOTHERCALIFORNIAMEDICARE ID - STANFORD SURGERY DEPT
2G97130MEDICARE UPINCALIFORNIA
3M95720072MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.