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Organization Active NPI

DLP Marquette Physician Practices Inc

Doing business as Marquette General Medical Clinic - Gladstone

  • Family Medicine Physician
  • Gladstone, MI
National Provider Identifier
1053667550
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DLP MARQUETTE PHYSICIAN PRACTICES INC
Doing business as
Marquette General Medical Clinic - Gladstone
Practice address
2002 Minneapolis Ave
Gladstone, MI 49837-2027
Phone
(906) 428-1856
Fax
(906) 728-1960
NPI assigned
Aug 2, 2012
Last updated
Mar 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
DLP MARQUETTE PHYSICIAN PRACTICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2002 Minneapolis Ave
Gladstone, MI 49837-2027

Mailing address

2002 Minneapolis Ave
Gladstone, MI 49837-2027
Phone (906) 428-1856

Other names 1

  • MARQUETTE GENERAL MEDICAL CLINIC - GLADSTONE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121016000312 MI Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 467 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marquette, MI; Negaunee, MI; Newberry, MI; Escanaba, MI; Ontonagon, MI; Sault Sainte Marie, MI; Ternary, MI; Manistique, MI…

Other NPIs on the same Medicare enrollment 33

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

View all 33

National Provider Directory

National Provider Directory
Part of
DLP Marquette Phys Prac LLC

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741478400000",
    "number": "1053667550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MINNEAPOLIS AVE",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498372027",
            "telephone_number": "906-428-1856",
            "fax_number": "906-728-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MINNEAPOLIS AVE",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498372027",
            "telephone_number": "906-428-1856",
            "fax_number": "906-728-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP MARQUETTE PHYSICIAN PRACTICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DLP MARQUETTE PHYSICIAN PRACTICES INC",
        "enumeration_date": "2012-08-02",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARQUETTE GENERAL MEDICAL CLINIC - GLADSTONE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gladstone, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2025; 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.