The Doctors Group, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

4301083010 Issued in MI

Legal business name

THE DOCTORS GROUP, PC

Doing business as

Wattles Park Family Practice

Practice address

1125 Michigan Ave E
Suite 5
Battle Creek, MI 49014-6832

Phone

(269) 969-4656

Fax

(269) 969-6085

NPI assigned

Sep 16, 2006

Last updated

Jan 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Barb C Vanhaitsma, CMA

Title

Practice Manager

Phone

(269) 969-4656

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Wattles Park Family Practice Doing business as

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1104922863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 MICHIGAN AVE E",
            "address_2": "SUITE 5",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490146832",
            "telephone_number": "269-969-4656",
            "fax_number": "269-969-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MICHIGAN AVE E",
            "address_2": "SUITE 5",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490146832",
            "telephone_number": "269-969-4656",
            "fax_number": "269-969-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOCTORS GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "VANHAITSMA",
        "authorized_official_first_name": "BARB",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "269-969-4656",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301083010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4227952",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4635366",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4300678",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wattles Park Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.