Active NPI
Northern Neurology, PLLC
- Neurology Physician
- Sault Sainte Marie, MI
National Provider Identifier
1104806827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 4301081266
- Legal business name
- NORTHERN NEUROLOGY, PLLC
- Practice address
- 550 Osborn Blvd
Sault Sainte Marie, MI 49783-1899 - Phone
- (906) 253-9136
- NPI assigned
- Jan 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Craig T Coccia, M.D.
- Title
- President
- Phone
- (906) 225-4575
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 4301081266 | MI | Primary |
Addresses
Primary practice location
550 Osborn Blvd
Sault Sainte Marie, MI 49783-1899
Mailing address
1414 W Fair Ave
Suite 348
Marquette, MI 49855-2675
Phone (906) 225-3964
National Provider Directory
National Provider DirectoryLocations
748 S Main St
Ste 6
Cheboygan, MI 49721
Phone (231) 627-5601
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Neurology Physician
- Saint Ignace, MI
- NPI 1700866415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1104806827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 W FAIR AVE",
"address_2": "SUITE 348",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498552675",
"telephone_number": "906-225-3964",
"fax_number": "906-226-3875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 OSBORN BLVD",
"city": "SAULT SAINTE MARIE",
"state": "MI",
"postal_code": "497831899",
"telephone_number": "906-253-9136"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN NEUROLOGY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-19",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "COCCIA",
"authorized_official_first_name": "CRAIG",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "906-225-4575",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MI",
"license": "4301081266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sault Sainte Marie, 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.