NPIMap

Organization Active NPI

Three Rivers Health Authority

Doing business as Three Rivers Health Family Care Three Rivers

  • Rural Health Clinic/Center
  • Three Rivers, MI
National Provider Identifier
1114902756
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
750020 Issued in MI
Legal business name
THREE RIVERS HEALTH AUTHORITY
Doing business as
Three Rivers Health Family Care Three Rivers
Practice address
721 6TH Ave
Suite a
Three Rivers, MI 49093-9387
Phone
(269) 273-9782
Fax
(269) 273-9711
NPI assigned
Dec 7, 2005
Organization subpart
Yes
Parent organization
THREE RIVERS HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Authorized official

Name
William Russell
Title
Ceo/President
Phone
(269) 273-9601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 750020 MI Primary

Addresses

Primary practice location

721 6TH Ave
Suite a
Three Rivers, MI 49093-9387

Mailing address

701 S Health Pkwy
Medical Staff Office
Three Rivers, MI 49093-8352
Phone (269) 273-9789

Other identifiers 1

IdentifierTypeStateIssuer
700G560080OtherMIBCBSM

Other names 1

  • Three Rivers Health Family Care Three Rivers Doing business as

National Provider Directory

National Provider Directory
Part of
Three Rivers Area Hospi

Practitioners & affiliated clinicians

Practitioners 2

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": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1114902756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S HEALTH PKWY",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938352",
            "telephone_number": "269-273-9789",
            "fax_number": "269-273-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 6TH AVE",
            "address_2": "SUITE A",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490939387",
            "telephone_number": "269-273-9782",
            "fax_number": "269-273-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS HEALTH AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THREE RIVERS HEALTH",
        "enumeration_date": "2005-12-07",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "269-273-9601"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": "750020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "700G560080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Health Family Care Three Rivers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.