Active NPI
Portage Health, Inc
- Durable Medical Equipment & Medical Supplies
- Hancock, MI
National Provider Identifier
1295909620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- PORTAGE HEALTH, INC
- Practice address
- 500 Campus Dr
Hancock, MI 49930-1569 - Phone
- (906) 483-1000
- NPI assigned
- Apr 16, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James Bogan
- Title
- President/Ceo
- Phone
- (906) 483-1500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
500 Campus Dr
Hancock, MI 49930-1569
Mailing address
500 Campus Dr
Hancock, MI 49930-1569
Phone (906) 483-1000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2988984 | Medicaid | MI | |
| 0C16002 | Other | MI | PROFESSIONAL GROUP |
| 540C106010 | Other | MI | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Member organizations 10
Organizations listed as members of this organization in the National Provider Directory.
Locations
500 Campus Dr
Ste B
Hancock, MI 49930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1374796800000",
"number": "1295909620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 CAMPUS DR",
"city": "HANCOCK",
"state": "MI",
"postal_code": "499301569",
"telephone_number": "906-483-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CAMPUS DR",
"city": "HANCOCK",
"state": "MI",
"postal_code": "499301569",
"telephone_number": "906-483-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORTAGE HEALTH, INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-16",
"last_updated": "2013-07-26",
"status": "A",
"authorized_official_last_name": "BOGAN",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "906-483-1500",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2988984",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL GROUP",
"identifier": "0C16002",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "540C106010",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hancock, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.