Active NPI
Huron Memorial Hospital
Doing business as McLaren Thumb Region - Port Austin Campus
- Family Medicine Physician
- Bad Axe, MI
National Provider Identifier
1083772826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- RL040876
- Legal business name
- HURON MEMORIAL HOSPITAL
- Doing business as
- McLaren Thumb Region - Port Austin Campus
- Practice address
- 1100 S Van Dyke Rd
Bad Axe, MI 48413-9615 - Phone
- (989) 269-9521
- Fax
- (989) 269-5260
- NPI assigned
- Dec 5, 2006
- Last updated
- Mar 28, 2019
- Organization subpart
- Yes
- Parent organization
- HURON MEMORIAL HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Eric Johnston
- Title
- President & Ceo
- Phone
- (989) 803-7127
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | RD002414 | MI | |
| Family Medicine Physician | 207Q00000X | RL040876 | MI | Primary |
Addresses
Primary practice location
1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Mailing address
1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-9521
Other names 1
- McLaren Thumb Region - Port Austin Campus
National Provider Directory
National Provider Directory- Part of
- McLaren Thumb Region
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553731200000",
"number": "1083772826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 S VAN DYKE RD",
"city": "BAD AXE",
"state": "MI",
"postal_code": "484139615",
"telephone_number": "989-269-9521",
"fax_number": "989-269-5260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 S VAN DYKE RD",
"city": "BAD AXE",
"state": "MI",
"postal_code": "484139615",
"telephone_number": "989-269-9521",
"fax_number": "989-269-5260"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HURON MEMORIAL HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HURON MEMORIAL HOSPITAL",
"enumeration_date": "2006-12-05",
"last_updated": "2019-03-28",
"status": "A",
"authorized_official_last_name": "JOHNSTON",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "ERIC",
"authorized_official_title_or_position": "PRESIDENT & CEO",
"authorized_official_telephone_number": "989-803-7127"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "RD002414",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "RL040876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "McLaren Thumb Region - Port Austin Campus",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bad Axe, MI
- Huron Isd
- Huron Medical Center (McLaren Thumb Region)
- Huron Medical Center (McLaren Thumb Region)
- Huron Medical Cneter (McLaren Thumb Region)
- Huron Memorial Hospital (McLaren Thumb Region)
- Huron Memorial Hospital (McLaren Thumb Region)
- Huron Memorial Hospital (McLaren Thumb Region)
- Huron Memorial Hospital (McLaren Thumb Region)
- Huron Memorial Hospital (McLaren Thumb Region)
- Huron Memorial Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.