NPIMap

Organization Active NPI

Wexford Medical Group

  • Family Medicine Physician
  • Cadillac, MI
National Provider Identifier
1366528200
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WEXFORD MEDICAL GROUP
Doing business as
GREAT LAKES FAMILY CARE
Practice address
520 Cobb St
Cadillac, MI 49601-2588
Phone
(231) 876-6521
Fax
(231) 876-6519
NPI assigned
Oct 31, 2006
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
Michael Zdrodowski
Title
Administrator
Phone
(231) 876-6730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

520 Cobb St
Cadillac, MI 49601-2588

Mailing address

520 Cobb St
Cadillac, MI 49601-2588
Phone (231) 876-6521

Other names 1

  • GREAT LAKES FAMILY CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Family Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366528200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-876-6521",
            "fax_number": "231-876-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-876-6521",
            "fax_number": "231-876-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEXFORD MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZDRODOWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "231-876-6730"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT LAKES FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cadillac, 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.