NPIMap

Organization Active NPI

Medexpress Urgent Care, PC - Michigan

Doing business as MedExpress Urgent Care - Jenison, Baldwin St

  • Urgent Care Clinic/Center
  • Jenison, MI
National Provider Identifier
1164879607
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDEXPRESS URGENT CARE, PC - MICHIGAN
Doing business as
MedExpress Urgent Care - Jenison, Baldwin St
Practice address
345 Baldwin St
Jenison, MI 49428-7988
Phone
(616) 667-2403
Fax
(616) 667-2459
NPI assigned
May 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Brett Gall
Title
Director Payor Contracting
Phone
(304) 225-2500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

345 Baldwin St
Jenison, MI 49428-7988

Mailing address

1001 Consol Energy Dr
Canonsburg, PA 15317-6506
Phone (304) 225-2500

Other names 1

  • MedExpress Urgent Care - Jenison, Baldwin St Doing business as

National Provider Directory

National Provider Directory

Locations

6929 S Westnedge Ave
Portage, MI 49002
Phone (269) 329-0202

Practitioners & affiliated clinicians

Practitioners 9

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": "1463184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1164879607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287988",
            "telephone_number": "616-667-2403",
            "fax_number": "616-667-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS URGENT CARE, PC - MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GALL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DIRECTOR PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress Urgent Care - Jenison, Baldwin St",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jenison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.