NPIMap

Organization Active NPI

Three Rivers Health

Doing business as Three Rivers Health Internal Medicine

  • Internal Medicine Physician
  • Three Rivers, MI
National Provider Identifier
1346224367
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
750020 Issued in MI
Legal business name
THREE RIVERS HEALTH
Doing business as
Three Rivers Health Internal Medicine
Practice address
711 S Health Pkwy
Suite 3
Three Rivers, MI 49093-9387
Phone
(269) 273-8557
Fax
(269) 279-6461
NPI assigned
Dec 2, 2005
Last updated
May 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
William Russell
Title
Chief Executive Officer
Phone
(269) 278-1145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 750020 MI Primary

Addresses

Primary practice location

711 S Health Pkwy
Suite 3
Three Rivers, MI 49093-9387

Mailing address

711 S Health Pkwy
Suite L-7
Three Rivers, MI 49093-9387
Phone (269) 273-9640

Other names 1

  • Three Rivers Health Internal Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

7901 S 12th St
Ste 101
Portage, MI 49024
Phone (269) 372-7200

7971 Moorsbridge Rd
Portage, MI 49024
Phone (269) 321-0929

1021 Hill St
Ste 300
Three Rivers, MI 49093
Phone (269) 858-2025

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1346224367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S HEALTH PKWY",
            "address_2": "SUITE L-7",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490939387",
            "telephone_number": "269-273-9640",
            "fax_number": "269-273-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S HEALTH PKWY",
            "address_2": "SUITE 3",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490939387",
            "telephone_number": "269-273-8557",
            "fax_number": "269-279-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-02",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "269-278-1145"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "750020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Health Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.

Verify at the official NPI Registry.