Portage Health Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PORTAGE HEALTH INC.

Doing business as

Portage Medical Group

Practice address

600 Macinnes Dr
Houghton, MI 49931-1144

Phone

(906) 483-1860

Fax

(906) 483-1815

NPI assigned

Oct 30, 2009

Last updated

Oct 30, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James Bogan

Title

Ceo

Phone

(906) 483-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Portage Medical Group Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Portage Health, Inc

  • Durable Medical Equipment & Medical Supplies
  • Hancock, MI
  • NPI 1295909620

  Member Of

  NPD member

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1063748770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 CAMPUS DR",
            "address_2": "STE B",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301571",
            "telephone_number": "906-483-1128",
            "fax_number": "906-483-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MACINNES DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311144",
            "telephone_number": "906-483-1860",
            "fax_number": "906-483-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "BOGAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "906-483-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "700C16002",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portage Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phillip Pietila, DC
• Regan Pitts
• Tina Marie Ploe, NURSE PRACTITIONER
• Lawrence John Pollack, PH.D.
• Portage Health Inc (Portage Health Express Care)
• Portage Physician Practices Inc (Up Medical Group - Portage Express Care)
• Portage Physician Practices Inc
• Portage Physician Practices Inc. (Portage Health Express Care)
• Public Counseling Services, LLC
• R & M Eye Care, P. C. (The Vision Clinic)

• Family Medicine Physician in Houghton, MI
• Providers in Houghton, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.