Organization Active NPI

Integrated Home Physicians PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Niles, MI
National Provider Identifier
1003390568
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
INTEGRATED HOME PHYSICIANS PLLC
Practice address
423 Sycamore St Ste 103
Niles, MI 49120-2374
Phone
(269) 479-3030
Fax
(269) 479-3032
NPI assigned
Sep 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Mark Fortune
Title
Vice President
Phone
(269) 479-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

423 Sycamore St Ste 103
Niles, MI 49120-2374

Mailing address

423 Sycamore St Ste 101
Niles, MI 49120-2374
Phone (269) 479-4040

National Provider Directory

National Provider Directory

Locations

423 Sycamore St
Ste 101
Niles, MI 49120

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1003390568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 SYCAMORE ST STE 101",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202374",
            "telephone_number": "269-479-4040",
            "fax_number": "269-479-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 SYCAMORE ST STE 103",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202374",
            "telephone_number": "269-479-3030",
            "fax_number": "269-479-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HOME PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "FORTUNE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "269-479-3030"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.