Active NPI
Parkway Plastic Surgery, P.C.
- Plastic and Reconstructive Surgery Physician
- Kalamazoo, MI
National Provider Identifier
1205983152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 4301039963
- Legal business name
- PARKWAY PLASTIC SURGERY, P.C.
- Practice address
- 575 W Crosstown Pkwy
Suite 1
Kalamazoo, MI 49008-1977 - Phone
- (269) 343-5750
- Fax
- (269) 343-4936
- NPI assigned
- Jan 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Steven Michael Nitsch, M.D.
- Title
- President
- Phone
- (269) 343-5750
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 4301039963 | MI | Primary |
Addresses
Primary practice location
575 W Crosstown Pkwy
Suite 1
Kalamazoo, MI 49008-1977
Mailing address
575 W Crosstown Pkwy
Suite 1
Kalamazoo, MI 49008-1977
Phone (269) 343-5750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4167184 | Medicaid | MI |
National Provider Directory
National Provider DirectoryLocations
575 W Crosstown Pkwy
Ste 100
Kalamazoo, MI 49008
575 W Crosstown Pkwy
Ste 1
Kalamazoo, MI 49008
Phone (269) 343-5750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205798400000",
"number": "1205983152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 W CROSSTOWN PKWY",
"address_2": "SUITE 1",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081977",
"telephone_number": "269-343-5750",
"fax_number": "269-343-4936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 W CROSSTOWN PKWY",
"address_2": "SUITE 1",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081977",
"telephone_number": "269-343-5750",
"fax_number": "269-343-4936"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARKWAY PLASTIC SURGERY, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-04",
"last_updated": "2008-03-18",
"status": "A",
"authorized_official_last_name": "NITSCH",
"authorized_official_first_name": "STEVEN",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "269-343-5750",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "MI",
"license": "4301039963",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4167184",
"state": "MI"
}
],
"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 Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.