NPIMap

Organization Active NPI

Community Hospital

  • Surgery Physician
  • Watervliet, MI
National Provider Identifier
1285891473
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
COMMUNITY HOSPITAL
Practice address
450 Medical Park Dr Ste 200
Watervliet, MI 49098-8531
Phone
(269) 463-3111
Fax
(269) 463-3581
NPI assigned
May 16, 2008
Last updated
Apr 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Authorized official

Name
Tim J Calhoun
Title
VP Finance/Cfo
Phone
(269) 983-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

450 Medical Park Dr Ste 200
Watervliet, MI 49098-8531

Mailing address

400 Medical Park Dr
Watervliet, MI 49098-9225
Phone (269) 983-8300

Other identifiers 1

IdentifierTypeStateIssuer
104947784MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Bangor Medical Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1285891473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225",
            "telephone_number": "269-983-8300",
            "fax_number": "269-463-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MEDICAL PARK DR STE 200",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490988531",
            "telephone_number": "269-463-3111",
            "fax_number": "269-463-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "CALHOUN",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP FINANCE/CFO",
        "authorized_official_telephone_number": "269-983-8300"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104947784",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watervliet, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.