NPIMap

Organization Active NPI

Mi Primary Care, PLLC

  • Primary Care Clinic/Center
  • Mt Pleasant, MI
National Provider Identifier
1104441302
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MI PRIMARY CARE, PLLC
Practice address
4950 E Blue Grass Rd
Mt Pleasant, MI 48858-6020
Phone
(989) 817-4640
Fax
(833) 974-2264
NPI assigned
Jun 12, 2020
Last updated
Nov 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Authorized official

Name
Roberta S Hahn, NPNPI 1770936866
Title
Manager
Phone
(989) 303-4101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4950 E Blue Grass Rd
Mt Pleasant, MI 48858-6020

Mailing address

4950 E Blue Grass Rd
Mt Pleasant, MI 48858-6020
Phone (989) 817-4640

Other practice location 1

224 N Mill St
Saint Louis, MI 48880-1523
Phone (989) 303-4101

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22056/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1104441302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 E BLUE GRASS RD",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488586020",
            "telephone_number": "989-817-4640",
            "fax_number": "833-974-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 E BLUE GRASS RD",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488586020",
            "telephone_number": "989-817-4640",
            "fax_number": "833-974-2264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 N Mill St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MI",
            "postal_code": "488801523",
            "country_code": "US",
            "telephone_number": "989-303-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MI PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "989-303-4101",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.