South Michigan Psychiatric Services LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301078095 Issued in MI

Legal business name

SOUTH MICHIGAN PSYCHIATRIC SERVICES LLC

Practice address

5390 Lovers LN
Third Floor
Portage, MI 49002

Phone

(269) 381-6950

Fax

(269) 381-6954

NPI assigned

May 7, 2011

Organization subpart

No

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

Authorized official

Name

Ruqiya Tareen, M.D.NPI 1598724122

Title

Medical Director

Phone

(269) 381-6950

Specialties & licenses 1

Addresses

Other names 1

• Kalamazoo TMS & Behavioral Health Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 4

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

• Ruqiya Shama Tareen, M.D.

  • Psychiatry Physician
  • Kalamazoo, MI
  • NPI 1598724122
  Medicare reassignment NPD Authorized official
• Shirley E Sanders, P.A.C.

  • Physician Assistant
  • Bangor, MI
  • NPI 1932194214
  Medicare reassignment
• Lauren Elizabeth Hanson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portage, MI
  • NPI 1225841380
  NPD
• Amy Jo Fritz, NP

  • Adult Health Nurse Practitioner
  • Portage, MI
  • NPI 1740748862
  NPD (past)

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

{
    "created_epoch": "1304726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1114219227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5930 LOVERS LN",
            "address_2": "THIRD FLOOR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021673",
            "telephone_number": "269-381-6950",
            "fax_number": "269-381-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5390 LOVERS LN",
            "address_2": "THIRD FLOOR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-381-6950",
            "fax_number": "269-381-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MICHIGAN PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-07",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "TAREEN",
        "authorized_official_first_name": "RUQIYA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "269-381-6950",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301078095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kalamazoo TMS & Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonder Psychology and Counseling, LLC
• Fiona Song
• Julie Marie Sorenson, L.L.P.C.
• Ismael Hiram Soto Rivas, M.D.
• Traci Ann Soule, CTRS
• South Michigan Psychiatric Services LLC
• Lindsay Page South, MA
• Southern Michigan Pain Consultants PC
• Southerncare, Inc.
• Southwest Footcare Specialists, P.C.

• Psychiatry Physician in Portage, MI
• Providers in Portage, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.