NPIMap

Organization Active NPI

Mecosta County Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Big Rapids, MI
National Provider Identifier
1366725954
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
540030 Issued in MI
Legal business name
MECOSTA COUNTY MEDICAL CENTER
Practice address
605 Oak St
Big Rapids, MI 49307-2048
Phone
(231) 796-8691
Fax
(231) 592-4494
NPI assigned
Sep 21, 2011
Last updated
Sep 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Authorized official

Name
Mr. Thomas S Daugherty
Title
Ceo
Phone
(231) 592-4205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 540030 MI Primary

Addresses

Primary practice location

605 Oak St
Big Rapids, MI 49307-2048

Mailing address

605 Oak St
Big Rapids, MI 49307-2048
Phone (231) 796-8691

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1366725954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OAK ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072048",
            "telephone_number": "231-796-8691",
            "fax_number": "231-592-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OAK ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072048",
            "telephone_number": "231-796-8691",
            "fax_number": "231-592-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECOSTA COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-592-4205",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "540030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.