Memorial Healthcare – General Practice Physician, NPI 1609073709
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Memorial Healthcare
103, West Main Street, Owosso, Shiawassee County, Michigan, 48867, United States
OWOSSO, MI 488678164
Phone: (989) 725-6528
Fax: (989) 723-9446
Type: Mailing
113 E WILLIAMS ST
OWOSSO, MI 488672360
Phone: (989) 725-6528
Fax: (989) 723-9446
Type: Mailing
9099 E LANSING RD STE B
DURAND, MI 484291083
Phone: (989) 288-0400
Fax: (989) 288-7862
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (47 days away).
Enrollment records
1
Earliest due date
2026-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040122000907 | O | Clinic/Group Practice | MI | 2026-07-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48867)
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