Organization Active NPI

Drummond Island Family Health Care,P.C.

  • Primary Care Clinic/Center
  • Drummond Island, MI
National Provider Identifier
1194759050
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
4704170765 Issued in MI
Legal business name
DRUMMOND ISLAND FAMILY HEALTH CARE,P.C.
Practice address
29745 E Channel Rd
Drummond Island, MI 49726-9699
Phone
(906) 493-6644
Fax
(906) 493-6666
NPI assigned
Jul 10, 2006
Last updated
Jan 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Authorized official

Name
Christine Cordray, FNP-CNPI 1114106812
Title
Nurse Practioner
Phone
(906) 493-6644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 4704170765 MI Primary

Addresses

Primary practice location

29745 E Channel Rd
Drummond Island, MI 49726-9699

Mailing address

29745 E Channel Rd
Drummond Island, MI 49726-9699
Phone (906) 493-6644

Other identifiers 1

IdentifierTypeStateIssuer
0A71060OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071130000265 MI Part B Supplier - Clinic/Group Practice 1254420102 Receives reassigned benefits from 1 practitioner
Practice locations: Drummond Island, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0937369Drummond Island Family Health Care PC29745 E Channel Road, Drummond Island, MI 49726Provider-performed microscopyNov 22, 2027

National Provider Directory

National Provider Directory

Locations

29745 E Channel Rd
Drummond Island, MI 49726
Phone (906) 493-6644

Practitioners & affiliated clinicians

Practitioners 2

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1194759050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29745 E CHANNEL RD",
            "city": "DRUMMOND ISLAND",
            "state": "MI",
            "postal_code": "497269699",
            "telephone_number": "906-493-6644",
            "fax_number": "906-493-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29745 E CHANNEL RD",
            "city": "DRUMMOND ISLAND",
            "state": "MI",
            "postal_code": "497269699",
            "telephone_number": "906-493-6644",
            "fax_number": "906-493-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRUMMOND ISLAND FAMILY HEALTH CARE,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "CORDRAY",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "NURSE PRACTIONER",
        "authorized_official_telephone_number": "906-493-6644",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4704170765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0A71060",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Drummond Island, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.