NPIMap

Organization Active NPI

County Health Support Services PLLC

  • Internal Medicine Physician
  • Traverse City, MI
National Provider Identifier
1033876271
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COUNTY HEALTH SUPPORT SERVICES PLLC
Practice address
320 Washington St
Traverse City, MI 49684-2548
Phone
(231) 922-4532
NPI assigned
Nov 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Authorized official

Name
Nazer D Abdel-Fattah, DO
Title
Medical Director
Phone
(231) 922-4532

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

320 Washington St
Traverse City, MI 49684-2548

Mailing address

610 W 11TH St
Traverse City, MI 49684-3150
Phone (313) 314-0617

National Provider Directory

National Provider Directory
Tax ID family
County Health Support Services PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

320 Washington St
Traverse City, MI 49684
Phone (231) 922-4532

NPI Registry JSON

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1033876271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W 11TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843150",
            "telephone_number": "313-314-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WASHINGTON ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842548",
            "telephone_number": "231-922-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY HEALTH SUPPORT SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "ABDEL-FATTAH",
        "authorized_official_first_name": "NAZER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "231-922-4532",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.