NPIMap

Organization Active NPI

Little River Band of Ottawa Indians

  • Federally Qualified Health Center (FQHC)
  • Norton Shores, MI
National Provider Identifier
1205515822
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LITTLE RIVER BAND OF OTTAWA INDIANS
Practice address
4905 Harvey St
Norton Shores, MI 49444-9763
Phone
(231) 655-3284
NPI assigned
Jul 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Dr. Daryl B WeverNPI 1386807212
Title
Director of Health Services
Phone
(231) 398-6852

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
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4905 Harvey St
Norton Shores, MI 49444-9763

Mailing address

4905 Harvey St
Norton Shores, MI 49444-9763
Phone (231) 655-3284

National Provider Directory

National Provider Directory
Tax ID family
Little River Band of Ottawa Indians6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1689120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1205515822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449763",
            "telephone_number": "231-655-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449763",
            "telephone_number": "231-655-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVER BAND OF OTTAWA INDIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "WEVER",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SERVICES",
        "authorized_official_telephone_number": "231-398-6852",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.