NPIMap

Organization Active NPI

Christian Global Medical Healthcare Incorporated

  • Urgent Care Clinic/Center
  • Portage, MI
National Provider Identifier
1063804995
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CHRISTIAN GLOBAL MEDICAL HEALTHCARE INCORPORATED
Practice address
451 W Milham Ave
Portage, MI 49024-2721
Phone
(269) 488-9007
Fax
(269) 488-9001
NPI assigned
Mar 2, 2015
Organization subpart
Yes
Parent organization
CHRISTIAN GLOBAL MEDICAL HEALTHCARE INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Authorized official

Name
Dr. Manjerngie Cecelia Ndebe, FNP-C, PHDNPI 1063562585
Title
Ceo
Phone
(269) 352-0655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

451 W Milham Ave
Portage, MI 49024-2721

Mailing address

451 W Milham Ave
Portage, MI 49024-2721
Phone (269) 488-9007

Other identifiers 1

IdentifierTypeStateIssuer
MI8282001OtherMIMEDICARE PTAN

Other names 1

  • Urgent Care Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150130000136 MI Part B Supplier - Clinic/Group Practice 4981928504 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portage, MI

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Christian Global Medical Healthcare Incorporated4 organizations share this tax ID, including this one
Part of
Christian Global Medical Healthcare Incorporated

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1063804995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 W MILHAM AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242721",
            "telephone_number": "269-488-9007",
            "fax_number": "269-488-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 W MILHAM AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242721",
            "telephone_number": "269-488-9007",
            "fax_number": "269-488-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN GLOBAL MEDICAL HEALTHCARE INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIAN GLOBAL MEDICAL HEALTHCARE INCORPORATED",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "NDEBE",
        "authorized_official_first_name": "MANJERNGIE",
        "authorized_official_middle_name": "CECELIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "269-352-0655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP-C, PHD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MI8282001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urgent Care Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.