Wexford Pho

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801086768 Issued in MI

Legal business name

WEXFORD PHO

Practice address

117 N Mitchell St
Ste. 6
Cadillac, MI 49601-1884

Phone

(231) 876-7139

Fax

(231) 775-4187

NPI assigned

Jun 6, 2016

Organization subpart

No

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

Authorized official

Name

Kim Speese

Title

Executive Director

Phone

(231) 876-7859

Specialties & licenses 1

Addresses

Tax ID family

Wexford Mercy Pho2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wexford Mercy Pho

  • Case Management Agency
  • Cadillac, MI
  • NPI 1922365014
  NPD tax ID

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1144679721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N MITCHELL ST",
            "address_2": "STE. 6",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011884",
            "telephone_number": "231-876-7139",
            "fax_number": "231-775-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N MITCHELL ST",
            "address_2": "STE. 6",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011884",
            "telephone_number": "231-876-7139",
            "fax_number": "231-775-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEXFORD PHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "SPEESE",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "231-876-7859"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wexford Medical Group (Great Lakes Family Care)
• Wexford Medical Group
• Wexford Medical Group (Great Lakes Family Care)
• Wexford Medical Group (Great Lakes Family Care)
• Wexford Mercy Pho
• Wexford Physician Services PC
• Wexford Senior Care Center, LLC
• Wexford-Missaukee Intermediate School District
• Steven G. Wheeler, LMSW, LPC
• James R Whelan, M.D,

• Clinical Social Worker in Cadillac, MI
• Providers in Cadillac, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.