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Dr. Isaac Deatherage , DO, MPH

General Practice β€’ Spring Lake, MI

Active NPI 1942998810 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

18627 144th Ave
Spring Lake, MI 494569520

Call 9188146422 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

18627 144th Ave

Spring Lake, MI 494569520

Telephone 9188146422
Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Ballout International Llc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Medical School

Pacific Nw Un Of Hs, Col Of Osteopathic Medicine

Graduation Year

2022

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

Years since graduation

4 years (graduated 2022)

CMS Doctors and Clinicians data list 2022 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Deatherage has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Deatherage as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Spring Lake and Michigan

2 active clinicians are listed under General Practice with a practice address in Spring Lake, MI (369 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-04-09
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

License # reported to NPPES MI 5101028511

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - GENERAL PRACTICE

Medicare Enrollment ID

I20250911000150

Enrollment State Jurisdiction

FL

PECOS Control ID

8921501586

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Ballout International Llc

1931 19th Pl, Vero Beach, FL 329603555

Phone: 3213879451

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location April 09, 2025

Registered at 18627 144TH AVE, SPRING LAKE, MI 494569520 (Tel: 9188146422)

πŸ“
Updated Business Mailing Address April 09, 2025

Registered at 18627 144TH AVE, SPRING LAKE, MI 494569520 (Tel: 9188146422)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2025

General Practice (license number reported to NPPES: MI 5101028511)

βœ…
NPI Profile Active April 27, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 27, 2023

Registered at 1675 LEAHY ST STE 315A, MUSKEGON, MI 494425543 (Tel: 2316728282)

πŸ“
Business Mailing Address (Initial Record) April 27, 2023

Registered at 1675 LEAHY ST STE 315A, MUSKEGON, MI 494425543

πŸ‘€
Provider Name / Credentials (Initial Record) April 27, 2023

Recorded as ISAAC DEATHERAGE, DO, MPH

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2023

Student in an Organized Health Care Education/Training Program (license number reported to NPPES: MI 5151016381)

🟒
Initial NPI Registration & Enumeration April 27, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1942998810
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2023
Last Update: April 09, 2025
Sole Proprietor: Yes

Mailing Address

18627 144th Ave

Spring Lake, MI 494569520

Phone: 9188146422

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.