NPIMap

Organization Active NPI

Michigan Medical Patient Care

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1194907089
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
MICHIGAN MEDICAL PATIENT CARE
Practice address
4100 Lake Dr SE
Suite 300
Grand Rapids, MI 49546-8292
Phone
(616) 974-4889
NPI assigned
Dec 3, 2007
Organization subpart
Yes
Parent organization
MICHIGAN MEDICAL PATIENT CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Authorized official

Name
Scott Harring
Title
Cfo
Phone
(616) 974-4889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X MI Primary

Addresses

Primary practice location

4100 Lake Dr SE
Suite 300
Grand Rapids, MI 49546-8292

Mailing address

4085 Burton St SE
Suite 200
Grand Rapids, MI 49546-2444

Other identifiers 1

IdentifierTypeStateIssuer
700D110880OtherMIBCBS PIN

National Provider Directory

National Provider Directory
Tax ID family
Michigan Med Spec PC70 organizations share this tax ID, including this one
Part of
Michigan Med Spec PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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": "1267488000000",
    "number": "1194907089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 BURTON ST SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "address_2": "SUITE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-974-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN MEDICAL PATIENT CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN MEDICAL PATIENT CARE",
        "enumeration_date": "2007-12-03",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "HARRING",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-974-4889"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "700D110880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.