NPIMap

Organization Active NPI

Mecosta County Medical Center

Doing business as Spectrum Health Bog Rapids Hospital

  • Hospitalist Physician
  • Big Rapids, MI
National Provider Identifier
1275866006
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
MECOSTA COUNTY MEDICAL CENTER
Doing business as
Spectrum Health Bog Rapids Hospital
Practice address
605 Oak St
Big Rapids, MI 49307-2048
Phone
(231) 796-8691
Fax
(231) 592-4494
NPI assigned
Sep 11, 2009
Last updated
Oct 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Authorized official

Name
Mr. Thomas Daugherty
Title
Ceo
Phone
(231) 592-4406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

605 Oak St
Big Rapids, MI 49307-2048

Mailing address

605 Oak St
Big Rapids, MI 49307-2048
Phone (231) 796-8691

Other names 1

  • Spectrum Health Bog Rapids Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000335 MI Part B Supplier - Clinic/Group Practice 1951215540 Receives reassigned benefits from 190 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Big Rapids, MI; Canadian Lakes, MI; Evart, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

8534 100TH Ave Ste 1
Stanwood, MI 49346

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1275866006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OAK ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072048",
            "telephone_number": "231-796-8691",
            "fax_number": "231-592-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OAK ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072048",
            "telephone_number": "231-796-8691",
            "fax_number": "231-592-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECOSTA COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-11",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-592-4406",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Health Bog Rapids Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Big Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.