Greater Niles Cardiology PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4301079120 Issued in MI

Legal business name

GREATER NILES CARDIOLOGY PC

Practice address

24 N Saint Joseph Ave
Suite F1
Niles, MI 49120-2263

Phone

(269) 687-9575

Fax

(269) 687-9596

NPI assigned

Nov 5, 2013

Organization subpart

No

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

Authorized official

Name

Tracy L Fortune

Title

Office Manager

Phone

(269) 687-9575

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1215366893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N SAINT JOSEPH AVE",
            "address_2": "SUITE F1",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202263",
            "telephone_number": "269-687-9575",
            "fax_number": "269-687-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 N SAINT JOSEPH AVE",
            "address_2": "SUITE F1",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202263",
            "telephone_number": "269-687-9575",
            "fax_number": "269-687-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER NILES CARDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "FORTUNE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-687-9575"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301079120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda M Gensolin MD PLLC
• Antonio Ray Gonzales, D.C.
• Emma Goodling
• Jill L Gorsuch, DO, MPH
• Darrin Gourlay, D.D.S.
• Greater Niles Chiropractic Health Center Incorporated
• Yvette Yolanda Greene
• Carrie Lynn Grellmann, RPT
• Taiyler Griffin
• Genna Marie Grondin, NP

• Cardiovascular Disease Physician in Niles, MI
• Providers in Niles, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.