Organization Active NPI

Parchment Family Practice, P.C.

  • Family Medicine Physician
  • Parchment, MI
National Provider Identifier
1295807741
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101011220 Issued in MI
Legal business name
PARCHMENT FAMILY PRACTICE, P.C.
Practice address
2350 E G Ave
Parchment, MI 49004-1943
Phone
(269) 344-6183
Fax
(269) 349-3046
NPI assigned
Nov 13, 2006
Last updated
Jan 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Authorized official

Name
Dr. Eric E Born, D.O.NPI 1386653913
Title
President
Phone
(269) 344-6173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101011220 MI Primary

Addresses

Primary practice location

2350 E G Ave
Parchment, MI 49004-1943

Mailing address

2350 E G Ave
Parchment, MI 49004-1943
Phone (269) 344-6183

Other identifiers 1

IdentifierTypeStateIssuer
114621039MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070109000207 MI Part B Supplier - Clinic/Group Practice 9133129505 Receives reassigned benefits from 3 practitioners
Practice locations: Parchment, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0662812Parchment Family Practice2350 East G Avenue, Parchment, MI 49004Certificate of waiverFeb 19, 2028

National Provider Directory

National Provider Directory

Locations

2350 E G Ave
Parchment, MI 49004
Phone (239) 344-6183

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEAFBA

Practitioners & affiliated clinicians

Practitioners 3

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1295807741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 E G AVE",
            "city": "PARCHMENT",
            "state": "MI",
            "postal_code": "490041943",
            "telephone_number": "269-344-6183",
            "fax_number": "269-349-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 E G AVE",
            "city": "PARCHMENT",
            "state": "MI",
            "postal_code": "490041943",
            "telephone_number": "269-344-6183",
            "fax_number": "269-349-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARCHMENT FAMILY PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "BORN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-344-6173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101011220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114621039",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parchment, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.