NPIMap

Organization Active NPI

Southwestern Michigan Emergency Services, PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kalamazoo, MI
National Provider Identifier
1013021310
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
SOUTHWESTERN MICHIGAN EMERGENCY SERVICES, PC
Practice address
125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone
(866) 898-7139
Fax
(616) 975-9827
NPI assigned
Aug 17, 2006
Last updated
Jul 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Authorized official

Name
Dr. James Demoss, DONPI 1194766469
Title
President
Phone
(269) 343-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MI Primary

Addresses

Primary practice location

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832

Mailing address

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone (866) 898-7139

Other identifiers 6

IdentifierTypeStateIssuer
700Z310360OtherMIBCBS
CC0530OtherMIRR MEDICARE
010C96159OtherMIBCBS
CN1229OtherMIRR MEDICARE
700H01007OtherMIBCBS
DC9527OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211000832 MI Part B Supplier - Clinic/Group Practice 1456265891 Receives reassigned benefits from 110 practitioners
Practice locations: Battle Creek, MI; Kalamazoo, MI; Paw Paw, MI; South Haven, MI

National Provider Directory

National Provider Directory

Locations

8116 Reliable Pkwy
Chicago, IL 60686

8138 Reliable Pkwy
Chicago, IL 60686

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone (269) 343-3900

Practitioners & affiliated clinicians

Practitioners 132

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 132

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1013021310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "866-898-7139",
            "fax_number": "616-975-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "866-898-7139",
            "fax_number": "616-975-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN MICHIGAN EMERGENCY SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "DEMOSS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-343-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700Z310360",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC0530",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010C96159",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CN1229",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700H01007",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DC9527",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.