NPIMap

Organization Active NPI

Healthcare Midwest PC

Doing business as HealthCare Midwest Physical Therapy

  • Physical Therapist
  • Kalamazoo, MI
National Provider Identifier
1356379374
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
HEALTHCARE MIDWEST PC
Doing business as
HealthCare Midwest Physical Therapy
Practice address
4613 W Main St
Suite C
Kalamazoo, MI 49006-2645
Phone
(269) 488-8360
Fax
(269) 488-8359
NPI assigned
Jun 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. James E McKernan
Title
Administrator
Phone
(269) 373-4646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

4613 W Main St
Suite C
Kalamazoo, MI 49006-2645

Mailing address

4613 W Main St
Suite C
Kalamazoo, MI 49006-2645
Phone (269) 488-8360

Other identifiers 1

IdentifierTypeStateIssuer
7173604OtherAETNA PIN

Other names 1

  • HealthCare Midwest Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dale G Moore RN13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356379374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 W MAIN ST",
            "address_2": "SUITE C",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062645",
            "telephone_number": "269-488-8360",
            "fax_number": "269-488-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 W MAIN ST",
            "address_2": "SUITE C",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062645",
            "telephone_number": "269-488-8360",
            "fax_number": "269-488-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE MIDWEST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKERNAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-373-4646",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7173604",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthCare Midwest Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.