Organization Active NPI

Michigan Emergency Physicians LLP

  • Emergency Medicine Physician
  • Clare, MI
National Provider Identifier
1174810238
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MICHIGAN EMERGENCY PHYSICIANS LLP
Practice address
703 N McEwan St
Clare, MI 48617-1440
Phone
(989) 802-5000
Fax
(989) 802-8800
NPI assigned
Jul 8, 2011
Last updated
Aug 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Authorized official

Name
Dr. Derik K King, M.D.NPI 1376560912
Title
Managing Partner
Phone
(239) 939-1717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

703 N McEwan St
Clare, MI 48617-1440

Mailing address

75 Remit Dr # 1122
Chicago, IL 60675-1122
Phone (866) 916-5259

Other identifiers 1

IdentifierTypeStateIssuer
1174810238MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090424000283 MI Part B Supplier - Clinic/Group Practice 7810045127 Receives reassigned benefits from 63 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hillsdale, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1174810238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DR # 1122",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751122",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171440",
            "telephone_number": "989-802-5000",
            "fax_number": "989-802-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN EMERGENCY PHYSICIANS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DERIK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "239-939-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174810238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clare, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.