Organization Active NPI

Peninsula Hospitalist Physicians, LLP

  • Hospitalist Physician
  • West Branch, MI
National Provider Identifier
1114333481
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
PENINSULA HOSPITALIST PHYSICIANS, LLP
Practice address
2463 S M 30
West Branch, MI 48661-9312
Phone
(989) 345-3660
NPI assigned
Jul 8, 2014
Last updated
Mar 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Derik K KingNPI 1376560912
Title
Managing Partner
Phone
(866) 916-5259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Hospitalist Physician 208M00000X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

2463 S M 30
West Branch, MI 48661-9312

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

National Provider Directory

National Provider Directory

Locations

75 Remit Dr 6900
Chicago, IL 60675

Practitioners & affiliated clinicians

Practitioners 1

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": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1114333481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698",
            "fax_number": "337-262-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2463 S M 30",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619312",
            "telephone_number": "989-345-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA HOSPITALIST PHYSICIANS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DERIK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "866-916-5259"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.