Dickinson County Healthcare System
Organization Active NPI Pulmonary Disease Physician · Iron Mountain, MI
NPI 1043635378 · NPPES record last updated Mar 13, 2014
Key facts
- NPI
- 1043635378
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- Legal business name
- DICKINSON COUNTY HEALTHCARE SYSTEM
- Practice address
- 1711 S Stephenson Ave
Suite 125
Iron Mountain, MI 49801-3639 - Phone
- (906) 776-5930
- Fax
- (906) 776-5901
- NPI assigned
- Feb 24, 2014
- Organization subpart
- No
Authorized official
- Name
- Alicia Henderson, CPC, CCP
- Title
- Physician Billing Supervisor
- Phone
- (906) 776-5665
Other NPIs on the same Medicare enrollment 20
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310000583 | MI | Part B Supplier - Clinic/Group Practice | 6800784943 |
Receives reassigned benefits from 156 practitioners 27 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Skandia, MI; Novi, MI; Munising, MI; Marquette, MI; Kingsford, MI; Ishpeming, MI; Iron River, MI; Iron Mountain, MI… |
| O20050623000153 | MI | Part B Supplier - Clinic/Group Practice | 6800784943 |
Receives reassigned benefits from 13 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Iron Mountain, MI; Norway, MI; Marquette, MI; Kingsford, MI; Ishpeming, MI; Iron River, MI; Bark River, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician |
207RP1001X | Yes |
Addresses
Primary practice location
1711 S Stephenson Ave
Suite 125
Iron Mountain, MI 49801-3639
Mailing address
PO Box 549
Iron Mountain, MI 49801-0549
Phone (906) 776-5930
Other names
- Dickinson Pulmonology Clinic
Other providers in Iron Mountain, MI
- Beth L Denell
- Erin Nicole Deprekel
- Bonnie Derocher
- Kathleen Dettman
- Dickinson County Healthcare System
- Dickinson County Healthcare System
- Dickinson County Healthcare System
- Dickinson County Healthcare System
- Dickinson County Healthcare System
- Dickinson County Healthcare System
All providers in Iron Mountain, MI · Pulmonary Disease Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.