Plastic Surgery of Kalamazoo,PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PLASTIC SURGERY OF KALAMAZOO,PC

Practice address

7901 South 12TH Street
Suite 100
Portage, MI 49024

Phone

(269) 372-3000

Fax

(269) 372-3500

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Rose M Johnson

Title

Manager, Patient Accounts

Phone

(269) 372-3000

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245452481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 SOUTH 12TH STREET",
            "address_2": "SUITE 100",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49024",
            "telephone_number": "269-372-3000",
            "fax_number": "269-372-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 SOUTH 12TH STREET",
            "address_2": "SUITE 100",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49024",
            "telephone_number": "269-372-3000",
            "fax_number": "269-372-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY OF KALAMAZOO,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER, PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "269-372-3000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1997100",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1920114",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Portage, MI
• Providers in Portage, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.