Active NPI
McLaren Bay Region
- Psychologist
- Essexville, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- 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
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary | ||
| Clinical Psychologist | 103TC0700X | |||
| Nurse Practitioner | 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
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5008702430 | Other | MI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations (25 of 37)
1900 Columbus Ave
Chicago, IL 60677
1060 S Van Dyke Rd
#200300
Bad Axe, MI 48413
3140 W Professional CT Ste 194
Bay City, MI 48706
1900 Columbus Ave
Unit 2E
Bay City, MI 48708
4 Columbus Ave
Ste 1200
Bay City, MI 48708
820 S Lincoln St
Bay City, MI 48708
1900 Columbus Ave
Fl S
Bay City, MI 48708
4175 N Euclid Ave
Ste 110
Bay City, MI 48706
3175 Professional Ct
Ste 102
Bay City, MI 48706
4 Columbus Ave
Ste 210
Bay City, MI 48708
Phone (989) 249-1922
3180 E Midland Rd
Bay City, MI 48706
Phone (989) 667-6670
3175 Professional Ct
Ste 1
Bay City, MI 48706
Phone (989) 895-4625
3175 Professional Ct
Unit 4
Bay City, MI 48706
3720 Katalin Ct
Ste 201
Bay City, MI 48706
Phone (989) 686-2800
4175 N Euclid Ave
Bay City, MI 48706
Phone (989) 667-2940
3140 W Campus Dr
Ste 194
Bay City, MI 48706
Phone (989) 667-2381
4 Columbus Ave
Ste 250
Bay City, MI 48708
Phone (989) 892-4591
4 Columbus Ave
Ste 160
Bay City, MI 48708
Phone (989) 377-4477
3140 W Campus Dr
Unit 4
Bay City, MI 48706
3175 Professional Ct
Ste 2
Bay City, MI 48706
Phone (989) 316-4010
1456 W Center Rd
Ste 1
Essexville, MI 48732
Phone (989) 895-4840
1480 W Center Rd
Essexville, MI 48732
Phone (989) 895-4625
1480 W Center Rd
Ste 5
Essexville, MI 48732
Phone (989) 894-4625
7340 Midland Rd
Freeland, MI 48623
Phone (989) 695-2123
801 Joe Mann Blvd
Ste A
Midland, MI 48642
Phone (989) 794-4025
Practitioners & affiliated clinicians
Practitioners 104
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Dearborn Heights, MI
- NPI 1396935946
-
- Hematology & Oncology Physician
- Bay City, MI
- NPI 1194715276
-
- Internal Medicine Physician
- Bay City, MI
- NPI 1528588159
-
- Cardiovascular Disease Physician
- Bay City, MI
- NPI 1588876130
-
- Student in an Organized Health Care Education/Training Program
- Bay City, MI
- NPI 1164319273
-
- Internal Medicine Physician
- Bay City, MI
- NPI 1881705580
-
- Student in an Organized Health Care Education/Training Program
- Bay City, MI
- NPI 1003749367
-
- Adult Health Nurse Practitioner
- Saginaw, MI
- NPI 1265642953
Nurse Practitioner
-
- Pediatrics Physician
- Essexville, MI
- NPI 1831171230
-
- Pediatrics Physician
- Essexville, MI
- NPI 1891777892
-
- Nurse Practitioner
- Grand Blanc, MI
- NPI 1992349732
-
- Surgical Physician Assistant
- Bay City, MI
- NPI 1508905977
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": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5008702430",
"state": "MI"
}
],
"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.