Coldwater Integrated Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

5101011799 Issued in MI

Legal business name

COLDWATER INTEGRATED MEDICINE

Practice address

892 E Chicago St
Suite a
Coldwater, MI 49036-2063

Phone

(517) 278-2519

NPI assigned

Jun 6, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Scott Russell, D.O.

Title

Principal Officer

Phone

(517) 278-2519

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coldwater Private Medicine Former legal business name

Locations

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1295148336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 E CHICAGO ST",
            "address_2": "SUITE A",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362063",
            "telephone_number": "517-278-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 E CHICAGO ST",
            "address_2": "SUITE A",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362063",
            "telephone_number": "517-278-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLDWATER INTEGRATED MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-06",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRINCIPAL OFFICER",
        "authorized_official_telephone_number": "517-278-2519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "5101011799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5101011799",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coldwater Private Medicine",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ashley M Clemons, DPT
• Debra Ann Coday
• Coldwater Chiropractic & Wellness Center, PLLC
• Coldwater Crossing Internal Medicine, PLLC.
• Coldwater Family Dentistry P.C.
• Coldwater JM Dental PC
• Coldwater Obstetrics & Gynecology, P.C.
• Coldwater Orthopaedics, PLLC
• Coldwater Radiology PC
• Coldwater Surgery PC

• Primary Care Clinic/Center in Coldwater, MI
• Providers in Coldwater, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.