NPIMap

Organization Active NPI

Internal Medicine Associates of Ludington, PC

  • Internal Medicine Physician
  • Ludington, MI
National Provider Identifier
1114118205
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101008322 Issued in MI
Legal business name
INTERNAL MEDICINE ASSOCIATES OF LUDINGTON, PC
Practice address
7 N Atkinson Dr
Suite 111
Ludington, MI 49431-1953
Phone
(231) 843-3487
Fax
(231) 843-1962
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Authorized official

Name
Dr. Ralph Avedisian, D. O., FACOI
Title
President
Phone
(231) 843-3487

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LC0200X 5101008322 MI
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 5101008322 MI Primary

Addresses

Primary practice location

7 N Atkinson Dr
Suite 111
Ludington, MI 49431-1953

Mailing address

7 N Atkinson Dr
Suite 111
Ludington, MI 49431-1953
Phone (231) 843-3487

Other identifiers 1

IdentifierTypeStateIssuer
2647582MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1114118205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N ATKINSON DR",
            "address_2": "SUITE 111",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3487",
            "fax_number": "231-843-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 N ATKINSON DR",
            "address_2": "SUITE 111",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3487",
            "fax_number": "231-843-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF LUDINGTON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "AVEDISIAN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-843-3487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. O., FACOI"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MI",
            "license": "5101008322",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101008322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2647582",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.