NPIMap

Organization Active NPI

Portage Health Inc

  • General Practice Physician
  • Houghton, MI
National Provider Identifier
1013247972
Registry record updated Apr 6, 2010
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
310020 Issued in MI
Legal business name
PORTAGE HEALTH INC
Practice address
921 W Sharon Ave.
Houghton, MI 49931
Phone
(906) 483-1000
NPI assigned
Dec 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Authorized official

Name
Mr. James Bogan
Title
Ceo
Phone
(906) 483-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 310020 MI Primary

Addresses

Primary practice location

921 W Sharon Ave.
Houghton, MI 49931

Mailing address

921 W Sharon Ave.
Houghton, MI 49931
Phone (906) 483-1000

Other names 1

  • PORTAGE HEALTH EXPRESS CARE Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1013247972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W SHARON AVE.",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "49931",
            "telephone_number": "906-483-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W SHARON AVE.",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "49931",
            "telephone_number": "906-483-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-28",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "BOGAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "906-483-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "310020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PORTAGE HEALTH EXPRESS CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houghton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.