Lake Huron OB GYN PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

NK013377 Issued in MI

Legal business name

LAKE HURON OB GYN PLLC

Practice address

1005 S Van Dyke Rd
Bad Axe, MI 48413-9614

Phone

(989) 269-3923

Fax

(989) 269-3983

NPI assigned

Nov 2, 2006

Organization subpart

No

Name

Dr. Nancy Bischer Macchiarella, D.O.

Title

Owner

Phone

(989) 269-3923

Locations

Interoperability endpoints

• Direct secure messaging: nmacchiarella33143@direct.covenanthealthcare.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 16, 2021.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1013095173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139614",
            "telephone_number": "989-269-3923",
            "fax_number": "989-269-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139614",
            "telephone_number": "989-269-3923",
            "fax_number": "989-269-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HURON OB GYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "MACCHIARELLA",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "BISCHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-269-3923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "NK013377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "1653210895",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "1603210171",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4624157",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4645433",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmacchiarella33143@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "1005 S Van Dyke Rd",
            "city": "Bad Axe",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484139614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian Christopher Krager
• Beth Krug
• Valerie Kubacki
• Aaron Kuhl
• Meg Christine Kunisch, OTRL
• Sherrie Lalonde
• Jennifer Lang
• Margaret Langley
• Shelley Ann Langley
• Vikki Stewart Lasota, R.D.

• All providers in Bad Axe, MI
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.