Prescott Clinic P.C.
Organization Active NPI Family Medicine Physician · Prescott, MI
NPI 1295248508 · NPPES record last updated Nov 8, 2017
Key facts
- NPI
- 1295248508
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PRESCOTT CLINIC P.C.
- Practice address
- 125 N Washington St
Prescott, MI 48756-5117 - Phone
- (989) 873-3352
- Fax
- (989) 873-3949
- NPI assigned
- Nov 8, 2017
- Organization subpart
- No
Authorized official
- Name
- William E Berner
- Title
- Administrator
- Phone
- (989) 892-7722
Other NPIs on the same Medicare enrollment 1
Practitioners 10
-
Melinda Lee Hawley, FNP-C
-
Nicholas Orow, M.D.
-
Shannon D Ahrens, P.A.
-
Richard Steven Gaft, ANCC, FNP
-
Linda Samborn, DO
-
Jimmie S Ward Sr., PA-C
-
Clinton Cornell, P.A.-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081121000527 | MI | Part B Supplier - Clinic/Group Practice | 0244147171 |
Receives reassigned benefits from 5 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Prescott, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
125 N Washington St
Prescott, MI 48756-5117
Mailing address
1003 Woodside Ave
Essexville, MI 48732-1234
Phone (989) 892-7722
Other providers in Prescott, MI
- Jalyn Jammer
- Karen'S Accounting Service, LLC
- Mad World Wellness PLLC
- Antonio F Mendiola Jr.
- Annemarie Catherine Poleck
- Prescott Clinic P.C.
- Prescott Physical Therapy, LLC
- Roos Pharmacy North, Inc.
- Skidway Pharmacy LLC
- Sterling Area Health Center
All providers in Prescott, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.