Organization Active NPI

Strategic Medical Services PC

  • Emergency Medicine Physician
  • Bay City, MI
National Provider Identifier
1154447035
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
STRATEGIC MEDICAL SERVICES PC
Practice address
1900 Columbus Ave
Bay City, MI 48708-6831
Phone
(989) 894-3145
Fax
(989) 894-6102
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Authorized official

Name
Dr. Kenneth Whiteside, MD
Title
President
Phone
(989) 894-3145

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 4301046418 MI
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1900 Columbus Ave
Bay City, MI 48708-6831

Mailing address

4100 Embassy Drive SE
Suite 200
Grand Rapids, MI 49546-2416
Phone (616) 975-1845

Other identifiers 2

IdentifierTypeStateIssuer
700Z911040OtherMIBCBS MI
700Z911040OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070608000062 MI Part B Supplier - Clinic/Group Practice 2860590247 Receives reassigned benefits from 2 practitioners
Practice locations: Bay City, MI

National Provider Directory

National Provider Directory

Locations

4100 Embassy Dr SE
Ste 200
Grand Rapids, MI 49546

Practitioners 2

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312156800000",
    "number": "1154447035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DRIVE SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416",
            "telephone_number": "616-975-1845",
            "fax_number": "616-285-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COLUMBUS AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086831",
            "telephone_number": "989-894-3145",
            "fax_number": "989-894-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRATEGIC MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-08-01",
        "status": "A",
        "authorized_official_last_name": "WHITESIDE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-894-3145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301046418",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "700Z911040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700Z911040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.