NPIMap

Organization Active NPI

Petoskey Family Medicine P.C.

  • Family Medicine Physician
  • Petoskey, MI
National Provider Identifier
1093703548
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301044355 Issued in MI
Legal business name
PETOSKEY FAMILY MEDICINE P.C.
Practice address
1890 S US 131
Suite 3
Petoskey, MI 49770-8344
Phone
(231) 487-6000
Fax
(231) 487-6014
NPI assigned
Oct 10, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Claudia A Santini
Title
Practice Manager
Phone
(231) 487-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301044355 MI Primary

Addresses

Primary practice location

1890 S US 131
Suite 3
Petoskey, MI 49770-8344

Mailing address

1890 S US 131
Suite 3
Petoskey, MI 49770-8344
Phone (231) 487-6000

Other identifiers 1

IdentifierTypeStateIssuer
4087341MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Petoskey Family Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 10

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": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093703548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 S US 131",
            "address_2": "SUITE 3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708344",
            "telephone_number": "231-487-6000",
            "fax_number": "231-487-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 S US 131",
            "address_2": "SUITE 3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708344",
            "telephone_number": "231-487-6000",
            "fax_number": "231-487-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETOSKEY FAMILY MEDICINE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANTINI",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "231-487-6000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301044355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4087341",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.