NPIMap

Organization Active NPI

Partridge Creek Obstetrics & Gynecology,P.C.

  • Obstetrics & Gynecology Physician
  • Macomb, MI
National Provider Identifier
1023107604
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101012054 Issued in MI
Legal business name
PARTRIDGE CREEK OBSTETRICS & GYNECOLOGY,P.C.
Practice address
19991 Hall Rd
Ste 105
Macomb, MI 48044
Phone
(586) 247-8609
Fax
(586) 247-8615
NPI assigned
Oct 12, 2006
Last updated
Apr 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Authorized official

Name
Dr. Rhonda L Kobold, D.O.
Title
President
Phone
(586) 247-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 5101012054 MI Primary

Addresses

Primary practice location

19991 Hall Rd
Ste 105
Macomb, MI 48044

Mailing address

19991 Hall Rd
Ste 105
Macomb, MI 48044-4254
Phone (586) 247-8609

Other identifiers 2

IdentifierTypeStateIssuer
4195410MedicaidMI
4195400MedicaidMI

National Provider Directory

National Provider Directory

Locations

15959 Hall Rd
Ste 301
Macomb, MI 48044
Phone (586) 247-8609

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1023107604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19991 HALL RD",
            "address_2": "STE 105",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480444254",
            "telephone_number": "586-247-8609",
            "fax_number": "586-247-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19991 HALL RD",
            "address_2": "STE 105",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "48044",
            "telephone_number": "586-247-8609",
            "fax_number": "586-247-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTRIDGE CREEK OBSTETRICS & GYNECOLOGY,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "KOBOLD",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-247-8609",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101012054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4195410",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4195400",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.