Active NPI
Portage Health Inc
- Skilled Nursing Facility
- Hancock, MI
National Provider Identifier
1306958491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- PORTAGE HEALTH INC
- Practice address
- 520 Campus Dr
Hancock, MI 49930-1569 - Phone
- (906) 483-1000
- NPI assigned
- Aug 31, 2006
- Organization subpart
- Yes
- Parent organization
- PORTAGE HEALTH INC
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
- Ceo
- Phone
- (906) 483-1501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
520 Campus Dr
Hancock, MI 49930-1569
Mailing address
520 Campus Dr
Hancock, MI 49930-1569
Phone (906) 483-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 622000126 | Medicaid | MI |
National Provider Directory
National Provider Directory- Part of
- Portage Health System
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1303430400000",
"number": "1306958491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 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": "520 CAMPUS DR",
"city": "HANCOCK",
"state": "MI",
"postal_code": "499301569",
"telephone_number": "906-483-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORTAGE HEALTH INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PORTAGE HEALTH INC",
"enumeration_date": "2006-08-31",
"last_updated": "2011-04-22",
"status": "A",
"authorized_official_last_name": "BOGAN",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "906-483-1501",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "622000126",
"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 Apr 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.