NPIMap

Organization Active NPI

McLaren Medical Group

  • Advanced Practice Midwife
  • Burton, MI
National Provider Identifier
1114066693
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Legal business name
MCLAREN MEDICAL GROUP
Practice address
1198 N Belsay Rd
Building 3
Burton, MI 48509-1669
Phone
(810) 743-5100
Fax
(810) 715-1807
NPI assigned
Feb 5, 2007
Last updated
Feb 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Mr. William Hardimon
Title
Ceo
Phone
(810) 342-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 367A00000X Primary

Addresses

Primary practice location

1198 N Belsay Rd
Building 3
Burton, MI 48509-1669

Mailing address

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-1000

Other identifiers 1

IdentifierTypeStateIssuer
420B512750OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • McLaren Medical Management, Inc. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000025 MI Part B Supplier - Clinic/Group Practice 3971416082 Receives reassigned benefits from 458 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1198 N Belsay Rd
Bldg 3
Burton, MI 48509
Phone (810) 715-9100

13109 Schavey Rd
Ste 1
Dewitt, MI 48820
Phone (517) 507-3001

Practitioners & affiliated clinicians

Practitioners 5

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": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1114066693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "810-342-1000",
            "fax_number": "810-342-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 N BELSAY RD",
            "address_2": "BUILDING 3",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091669",
            "telephone_number": "810-743-5100",
            "fax_number": "810-715-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "HARDIMON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-342-1040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "420B512750",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLaren Medical Management, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.