NPIMap

Organization Active NPI

Four Flags Urology, Inc.

  • Specialist
  • Niles, MI
National Provider Identifier
1144292939
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301103271 Issued in MI
Legal business name
FOUR FLAGS UROLOGY, INC.
Practice address
60 N Saint Joseph Ave
Suite E
Niles, MI 49120-2296
Phone
(269) 684-6696
Fax
(269) 684-5286
NPI assigned
Feb 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Mary Geegan Middleton
Title
Executive Director
Phone
(269) 684-0259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 4301103271 MI Primary

Addresses

Primary practice location

60 N Saint Joseph Ave
Suite E
Niles, MI 49120-2296

Mailing address

60 N Saint Joseph Ave
Suite E
Niles, MI 49120-2296
Phone (269) 684-6696

National Provider Directory

National Provider Directory

Locations

60 N Saint Joseph Ave
Ste E
Niles, MI 49120
Phone (269) 684-5910

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144292939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N SAINT JOSEPH AVE",
            "address_2": "SUITE E",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202296",
            "telephone_number": "269-684-6696",
            "fax_number": "269-684-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 N SAINT JOSEPH AVE",
            "address_2": "SUITE E",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202296",
            "telephone_number": "269-684-6696",
            "fax_number": "269-684-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR FLAGS UROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "GEEGAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "269-684-0259",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301103271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.