Mecosta County Radiology, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MECOSTA COUNTY RADIOLOGY, LLC

Practice address

605 Oak St
Big Rapids, MI 49307-2048

Phone

(231) 592-4212

Fax

(231) 592-4343

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Blase Vitello, M.D.

Title

Owner/President

Phone

(231) 592-4212

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas Martin Ellinger, MD

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
  • NPI 1295793511

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104831783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "address_2": "ATTN: LYNDA THOMPSON",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481061108",
            "telephone_number": "734-677-7400",
            "fax_number": "734-677-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OAK ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072048",
            "telephone_number": "231-592-4212",
            "fax_number": "231-592-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECOSTA COUNTY RADIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VITELLO",
        "authorized_official_first_name": "BLASE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "231-592-4212",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DB9242",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mecosta County Medical Center
• Mecosta County Medical Center
• Mecosta County Medical Center
• Mecosta County Medical Center
• Mecosta County Medical Center
• Mecosta Health Service, Inc.
• Mecosta Health Services, Inc
• Mecosta Osceola Transit Authority
• Mecosta-Osceola Intermediate School District
• Xue Mei, OD

• All providers in Big Rapids, MI
• Diagnostic Radiology Physician in Michigan

• 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.