NPIMap

Organization Active NPI

Memory and Movement Disorders Clinic, PLLC

Doing business as MMDC

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1265609960
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MEMORY AND MOVEMENT DISORDERS CLINIC, PLLC
Doing business as
MMDC
Practice address
1213 W Front St
Traverse City, MI 49684-2317
Phone
(231) 935-0386
Fax
(231) 935-0387
NPI assigned
May 12, 2008
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Diane S Parsons, MDNPI 1548263395
Title
Sole Member
Phone
(231) 935-0386

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
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1213 W Front St
Traverse City, MI 49684-2317

Mailing address

1213 W Front St
Traverse City, MI 49684-2317
Phone (231) 935-0386

Other names 1

  • MMDC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1265609960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842317",
            "telephone_number": "231-935-0386",
            "fax_number": "231-935-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842317",
            "telephone_number": "231-935-0386",
            "fax_number": "231-935-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORY AND MOVEMENT DISORDERS CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "PARSONS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "231-935-0386",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMDC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

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

Verify at the official NPI Registry.