NPIMap

Organization Active NPI

Mecosta County Medical Center

Doing business as Spectrum Health Big Rapids Hospital

  • Cardiovascular Disease Physician
  • Big Rapids, MI
National Provider Identifier
1386693471
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MECOSTA COUNTY MEDICAL CENTER
Doing business as
Spectrum Health Big Rapids Hospital
Practice address
605 Oak St
Big Rapids, MI 49307-2048
Phone
(231) 592-4407
Fax
(231) 592-4494
NPI assigned
May 8, 2006
Last updated
Sep 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Mr. Thomas Daugherty
Title
Ceo
Phone
(231) 592-4407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 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) 592-4407

Other names 1

  • Spectrum Health Big Rapids Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000335 MI Part B Supplier - Clinic/Group Practice 1951215540 Receives reassigned benefits from 190 practitioners
4 other NPIs on this enrollment
Practice locations: Big Rapids, MI; Canadian Lakes, MI; Evart, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

Practitioners & affiliated clinicians

Practitioners 198

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 198

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1386693471",
    "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": "231-592-4407",
            "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": "231-592-4407",
            "fax_number": "231-592-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECOSTA COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-592-4407",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Health Big Rapids Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.