NPIMap

Organization Active NPI

Opus Medicine, PC

  • Specialist
  • Kalamazoo, MI
National Provider Identifier
1013286228
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OPUS MEDICINE, PC
Practice address
3601 S 9TH St
Kalamazoo, MI 49009-9538
Phone
(269) 383-6789
Fax
(269) 383-6767
NPI assigned
Dec 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Dr. Stephen N Dallas, M.D.NPI 1356393482
Title
Owner/President
Phone
(269) 383-6789

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3601 S 9TH St
Kalamazoo, MI 49009-9538

Mailing address

3601 S 9TH St
Kalamazoo, MI 49009-9538
Phone (269) 383-6789

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120215000660 MI Part B Supplier - Clinic/Group Practice 6901064294 Practice locations: Kalamazoo, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1013286228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 S 9TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099538",
            "telephone_number": "269-383-6789",
            "fax_number": "269-383-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S 9TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099538",
            "telephone_number": "269-383-6789",
            "fax_number": "269-383-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPUS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "DALLAS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "269-383-6789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 16, 2011; 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.