NPIMap

Organization Active NPI

Mercy Surgery Care Network

  • Surgery Physician
  • Port Huron, MI
National Provider Identifier
1114236353
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101011284 Issued in MI
Legal business name
MERCY SURGERY CARE NETWORK
Practice address
2609 Electric Ave
Suite B
Port Huron, MI 48060-6589
Phone
(810) 985-1868
NPI assigned
Oct 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Authorized official

Name
Nancy Mason
Title
Executive Director
Phone
(810) 985-1868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 5101011284 MI Primary

Addresses

Primary practice location

2609 Electric Ave
Suite B
Port Huron, MI 48060-6589

Mailing address

PO Box 610669
Port Huron, MI 48061-0669
Phone (810) 985-1884

Other identifiers 1

IdentifierTypeStateIssuer
4844446MedicaidMI

National Provider Directory

National Provider Directory

Locations

2609 Electric Ave
Ste B
Port Huron, MI 48060
Phone (810) 984-1148

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1114236353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610669",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480610669",
            "telephone_number": "810-985-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 ELECTRIC AVE",
            "address_2": "SUITE B",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606589",
            "telephone_number": "810-985-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY SURGERY CARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "810-985-1868"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101011284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4844446",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.