NPIMap

Organization Active NPI

Borgess Medical Center

  • Psychologist
  • Kalamazoo, MI
National Provider Identifier
1194907071
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BORGESS MEDICAL CENTER
Practice address
1521 Gull Road
Kalamazoo, MI 49048
Phone
(269) 226-7000
NPI assigned
Dec 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Edward Millermaier
Title
Cmo
Phone
(269) 552-2910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1521 Gull Road
Kalamazoo, MI 49048

Mailing address

5943 Stadium Drive
Kalamazoo, MI 49009

Other identifiers 1

IdentifierTypeStateIssuer
P10C91094OtherBCBSM TRADITIONAL

National Provider Directory

National Provider Directory
Tax ID family
Brogess Medical Center17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 1

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": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1194907071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DRIVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 GULL ROAD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49048",
            "telephone_number": "269-226-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORGESS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "MILLERMAIER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "269-552-2910"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM TRADITIONAL",
            "identifier": "P10C91094",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.