NPIMap

Organization Active NPI

Isabella Citizens for Health, Inc.

  • Family Medicine Physician
  • Saint Louis, MI
National Provider Identifier
1043864010
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ISABELLA CITIZENS FOR HEALTH, INC.
Practice address
113 E Saginaw St
Saint Louis, MI 48880-1755
Phone
(989) 953-5320
NPI assigned
Jul 29, 2019
Organization subpart
Yes
Parent organization
ISABELLA CITIZENS FOR HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Lydia Rose Stevens
Title
Billing/Revenue Cycle Coordinator
Phone
(989) 779-5642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

113 E Saginaw St
Saint Louis, MI 48880-1755

Mailing address

2790 Health Pkwy
Mt Pleasant, MI 48858-9342
Phone (989) 953-5320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130516000164 MI Part B Supplier - Clinic/Group Practice 9335386051 Receives reassigned benefits from 38 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Farwell, MI; Mount Pleasant, MI

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Isabella Citizens for Health Inc

Practitioners & affiliated clinicians

Practitioners 1

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": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1043864010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488589342",
            "telephone_number": "989-953-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E SAGINAW ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801755",
            "telephone_number": "989-953-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISABELLA CITIZENS FOR HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISABELLA CITIZENS FOR HEALTH, INC.",
        "enumeration_date": "2019-07-29",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "BILLING/REVENUE CYCLE COORDINATOR",
        "authorized_official_telephone_number": "989-779-5642"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.