NPIMap

Organization Active NPI

Oakland Physicians Medical Center, LLC

  • Certified Registered Nurse Anesthetist
  • Pontiac, MI
National Provider Identifier
1134370752
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
OAKLAND PHYSICIANS MEDICAL CENTER, LLC
Doing business as
Pontiac General Hospital
Practice address
461 West Huron Street
Pontiac, MI 48341
Phone
(248) 857-7200
Fax
(248) 857-6842
NPI assigned
Oct 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Authorized official

Name
Mr. Timothy Jodway
Title
Chief Financial Officer
Phone
(248) 857-7200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

461 West Huron Street
Pontiac, MI 48341

Mailing address

461 West Huron Street
Pontiac, MI 48341
Phone (248) 857-7200

Other identifiers 1

IdentifierTypeStateIssuer
5435510MedicaidMI

Other names 1

  • Pontiac General Hospital Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504828800000",
    "number": "1134370752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 WEST HURON STREET",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-857-7200",
            "fax_number": "248-857-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 WEST HURON STREET",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-857-7200",
            "fax_number": "248-857-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND PHYSICIANS MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2017-09-08",
        "status": "A",
        "authorized_official_last_name": "JODWAY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "248-857-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5435510",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pontiac General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.