NPIMap

Organization Active NPI

Midmichigan Cardiology

  • Specialist
  • Midland, MI
National Provider Identifier
1356559041
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301065098 Issued in MI
Legal business name
MIDMICHIGAN CARDIOLOGY
Practice address
111 E Wackerly St
Suite D
Midland, MI 48642-7001
Phone
(989) 832-0100
Fax
(989) 923-1055
NPI assigned
May 18, 2007
Last updated
Oct 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Authorized official

Name
Nathaniel Rhode Woodruff, M.D., PH.D.NPI 1275623191
Title
President
Phone
(989) 832-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301065098 MI Primary

Addresses

Primary practice location

111 E Wackerly St
Suite D
Midland, MI 48642-7001

Mailing address

111 E Wackerly St
Suite D
Midland, MI 48642-7001
Phone (989) 832-0100

Other identifiers 2

IdentifierTypeStateIssuer
3423708MedicaidMI
NW0560042OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Midmichigan Cardiology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1356559041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WACKERLY ST",
            "address_2": "SUITE D",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427001",
            "telephone_number": "989-832-0100",
            "fax_number": "989-923-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WACKERLY ST",
            "address_2": "SUITE D",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427001",
            "telephone_number": "989-832-0100",
            "fax_number": "989-923-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDMICHIGAN CARDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "RHODE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-832-0100",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301065098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3423708",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NW0560042",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; 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.