Organization Active NPI

McLaren Primary Care

  • Family Medicine Physician
  • Prudenville, MI
National Provider Identifier
1255352936
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCLAREN PRIMARY CARE
Practice address
200 N. Grand Ave
Prudenville, MI 48651
Phone
(989) 366-1000
Fax
(989) 366-1002
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Danielle C Jacks Porter
Title
VP/Cfo
Phone
(989) 894-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

200 N. Grand Ave
Prudenville, MI 48651

Mailing address

1900 Columbus Ave
Attn: McLaren Bay Region Ceo
Bay City, MI 48708-6831

National Provider Directory

National Provider Directory

Locations

200 Grand Ave
Prudenville, MI 48651
Phone (989) 366-1000

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1255352936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 COLUMBUS AVE",
            "address_2": "ATTN: MCLAREN BAY REGION CEO",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N. GRAND AVE",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "48651",
            "telephone_number": "989-366-1000",
            "fax_number": "989-366-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "JACKS PORTER",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "989-894-3838"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prudenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.