NPIMap

Organization Active NPI

Huron Memorial Hospital Employed Physicians

Doing business as Huron Medical Center Employed Physicians

  • Family Medicine Physician
  • Bad Axe, MI
National Provider Identifier
1275629917
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DG076330 Issued in MI
Legal business name
HURON MEMORIAL HOSPITAL EMPLOYED PHYSICIANS
Doing business as
Huron Medical Center Employed Physicians
McLaren Thumb Region - Employed Physicians
Practice address
1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone
(989) 269-9521
NPI assigned
Oct 4, 2006
Last updated
Mar 28, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
HURON MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Authorized official

Name
Michael Eric Johnston
Title
President & Ceo
Phone
(989) 803-7127

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL040876 MI
Family Medicine Physician 207Q00000X DG076330 MI Primary
Internal Medicine Physician 207R00000X TM078893 MI
Internal Medicine Physician 207R00000X GG072192 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MM077123 MI
Neurology Physician 2084N0400X JK014129 MI
Surgery Physician 208600000X SN084671 MI
Urology Physician 208800000X DB039784 MI

Addresses

Primary practice location

1100 S Van Dyke Rd
Bad Axe, MI 48413-9615

Mailing address

1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-9521

Other names 2

  • Huron Medical Center Employed Physicians Doing business as
  • McLaren Thumb Region - Employed Physicians Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Huron Memorial Hosp16 organizations share this tax ID, including this one
Part of
Huron Memorial Hosp

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1275629917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139615",
            "telephone_number": "989-269-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139615",
            "telephone_number": "989-269-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON MEMORIAL HOSPITAL EMPLOYED PHYSICIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HURON MEMORIAL HOSPITAL",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "989-803-7127"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "RL040876",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DG076330",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "TM078893",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "GG072192",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "MM077123",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "JK014129",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "SN084671",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "DB039784",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huron Medical Center Employed Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McLaren Thumb Region - Employed Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bad Axe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.