Active NPI
Strategic Medical Services PC
- Emergency Medicine Physician
- Bay City, MI
National Provider Identifier
1154447035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | |||
| Emergency Medicine Physician | 207P00000X | 4301046418 | MI | |
| Emergency Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700Z911040 | Other | MI | BCBS MI |
| 700Z911040 | Other | MI | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.