NPIMap

Organization Active NPI

Mercy Health Partners

Doing business as Business Health Solutions - Broadmoor

  • Family Medicine Physician
  • Caledonia, MI
National Provider Identifier
1336764232
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY HEALTH PARTNERS
Doing business as
Business Health Solutions - Broadmoor
Practice address
7105 Broadmoor Ave SE
Caledonia, MI 49316-9510
Phone
(616) 685-7900
Fax
(616) 685-7909
NPI assigned
Jun 16, 2020
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Betty Eller
Title
Credentailing Coordinator
Phone
(231) 672-2120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

7105 Broadmoor Ave SE
Caledonia, MI 49316-9510

Mailing address

7105 Broadmoor Ave SE
Caledonia, MI 49316-9510
Phone (616) 685-7900

Other names 1

  • Business Health Solutions - Broadmoor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mercy Health Partners20 organizations share this tax ID, including this one
Part of
Mercy Health Partners

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

7105 Broadmoor Ave SE
Caledonia, MI 49316
Phone (616) 604-4104

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1336764232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 BROADMOOR AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169510",
            "telephone_number": "616-685-7900",
            "fax_number": "616-685-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105 BROADMOOR AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169510",
            "telephone_number": "616-685-7900",
            "fax_number": "616-685-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH PARTNERS",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "ELLER",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "CREDENTAILING COORDINATOR",
        "authorized_official_telephone_number": "231-672-2120"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Business Health Solutions - Broadmoor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caledonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.