NPIMap

Organization Active NPI

Medical Arts Pediatrics, PLC

  • Pediatrics Physician
  • Mt Pleasant, MI
National Provider Identifier
1275792301
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
SW053546 Issued in MI
Legal business name
MEDICAL ARTS PEDIATRICS, PLC
Practice address
1201 South Dr
Suite 341
Mt Pleasant, MI 48858-3256
Phone
(989) 779-5270
Fax
(989) 779-5279
NPI assigned
Jun 4, 2008
Last updated
Jun 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Steven G Walvisch, M.D.NPI 1497792238
Title
President
Phone
(989) 779-5270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X SW053546 MI Primary

Addresses

Primary practice location

1201 South Dr
Suite 341
Mt Pleasant, MI 48858-3256

Mailing address

1201 South Dr
Suite 341
Mt Pleasant, MI 48858-3256
Phone (989) 779-5270

Other identifiers 4

IdentifierTypeStateIssuer
0371044OtherMIBCBS
4875756MedicaidMI
0370053OtherMIBCBS
4344387MedicaidMI

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": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1275792301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SOUTH DR",
            "address_2": "SUITE 341",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583256",
            "telephone_number": "989-779-5270",
            "fax_number": "989-779-5279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SOUTH DR",
            "address_2": "SUITE 341",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583256",
            "telephone_number": "989-779-5270",
            "fax_number": "989-779-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ARTS PEDIATRICS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "WALVISCH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-779-5270",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "SW053546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0371044",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4875756",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0370053",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4344387",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.