Organization Active NPI

Daoud Surgery & Family Medicine PC

  • Family Medicine Physician
  • Coldwater, MI
National Provider Identifier
1144435009
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
CD51012553 Issued in MI
Legal business name
DAOUD SURGERY & FAMILY MEDICINE PC
Practice address
356 E Chicago St
Suite a
Coldwater, MI 49036-2057
Phone
(517) 278-3675
Fax
(517) 279-0049
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Authorized official

Name
Trina Miller
Title
Office Manager
Phone
(517) 278-2675

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X CD51012553 MI Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

356 E Chicago St
Suite a
Coldwater, MI 49036-2057

Mailing address

356 E Chicago St
Suite a
Coldwater, MI 49036-2057
Phone (517) 278-3675

Other identifiers 2

IdentifierTypeStateIssuer
4528160MedicaidMI
4528150MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080701000347 MI Part B Supplier - Clinic/Group Practice 0648342907 Receives reassigned benefits from 2 practitioners
Practice locations: Coldwater, MI
O20220128002108 IN Part B Supplier - Clinic/Group Practice 0648342907 Receives reassigned benefits from 1 practitioner
Practice locations: Fremont, IN

National Provider Directory

National Provider Directory

Locations

356 E Chicago St
Ste A
Coldwater, MI 49036
Phone (517) 278-3675

356 E Chicago St
Coldwater, MI 49036
Phone (517) 278-3675

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1144435009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 E CHICAGO ST",
            "address_2": "SUITE A",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362057",
            "telephone_number": "517-278-3675",
            "fax_number": "517-279-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 E CHICAGO ST",
            "address_2": "SUITE A",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362057",
            "telephone_number": "517-278-3675",
            "fax_number": "517-279-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAOUD SURGERY & FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TRINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "517-278-2675"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "CD51012553",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4528160",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4528150",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.