NPIMap

Organization Active NPI

McLaren Bay Region

  • Psychologist
  • Essexville, MI
National Provider Identifier
1013056233
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MCLAREN BAY REGION
Practice address
1480 W Center Rd
Essexville, MI 48732
Phone
(989) 895-4625
Fax
(989) 895-4626
NPI assigned
Feb 5, 2007
Last updated
Aug 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Authorized official

Name
Danielle C Jacks Porter
Title
Cfo
Phone
(989) 894-3838

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1480 W Center Rd
Essexville, MI 48732

Mailing address

1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416000730 MI Part B Supplier - Clinic/Group Practice 5597659011 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, MI; Essexville, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 13

Organizations listed as members of this organization in the National Provider Directory.

View all 13

Locations (25 of 29)

1900 Columbus Ave
Chicago, IL 60677

1060 S Van Dyke Rd
#200300
Bad Axe, MI 48413

1100 S Van Dyke Rd
Bad Axe, MI 48413
Phone (989) 269-9521

1900 Columbus Ave
Fl S
Bay City, MI 48708

1900 Columbus Ave
Unit 2E
Bay City, MI 48708

200 S Wenona St
Ste 195
Bay City, MI 48706
Phone (313) 497-2665

3140 W Campus Dr
Unit 4
Bay City, MI 48706

3140 W Professional CT Ste 194
Bay City, MI 48706

3175 Professional Ct
Ste 102
Bay City, MI 48706

3175 Professional Ct
Ste 2
Bay City, MI 48706
Phone (989) 316-4010

3175 Professional Ct
Unit 4
Bay City, MI 48706

4 Columbus Ave
Ste 1200
Bay City, MI 48708

4175 N Euclid Ave
Ste 10
Bay City, MI 48706
Phone (989) 671-9513

4175 N Euclid Ave
Ste 11
Bay City, MI 48706

4175 N Euclid Ave
Ste 110
Bay City, MI 48706

820 S Lincoln St
Bay City, MI 48708

901 S Henry St
Bay City, MI 48706
Phone (989) 894-9000

10090 E Lippincott Blvd
Davison, MI 48423
Phone (810) 653-1130

1458 W Center Rd
Essexville, MI 48732
Phone (989) 895-4625

1458 W Center Rd
Ste 1
Essexville, MI 48732
Phone (989) 895-4625

111 W Wackerly St
Midland, MI 48640

555 W Wackerly St
Ste 260
Midland, MI 48640

801 Joe Mann Blvd
Ste A
Midland, MI 48642
Phone (989) 794-4025

2891 Health Pkwy Ste B
Mount Pleasant, MI 48858

1201 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6880

Practitioners & affiliated clinicians

Practitioners 92

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 92

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1013056233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 COLUMBUS AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086831",
            "telephone_number": "989-894-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 W CENTER RD",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "48732",
            "telephone_number": "989-895-4625",
            "fax_number": "989-895-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN BAY REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "JACKS PORTER",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "989-894-3838"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essexville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.