Portage Health Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PORTAGE HEALTH INC.

Practice address

945 9TH St
Lake Linden, MI 49945-1100

Phone

(906) 483-1030

Fax

(906) 296-0521

NPI assigned

Oct 23, 2009

Organization subpart

No

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

Authorized official

Name

James Bogan

Title

Ceo

Phone

(906) 483-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Portage Medical Group Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Portage Health, Inc

  • Durable Medical Equipment & Medical Supplies
  • Hancock, MI
  • NPI 1295909620

  Member Of

  NPD member

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256256000000",
    "number": "1386970481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 CAMPUS DR",
            "address_2": "STE. B",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301571",
            "telephone_number": "906-483-1128",
            "fax_number": "906-483-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 9TH ST",
            "city": "LAKE LINDEN",
            "state": "MI",
            "postal_code": "499451100",
            "telephone_number": "906-483-1030",
            "fax_number": "906-296-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-23",
        "last_updated": "2009-10-23",
        "status": "A",
        "authorized_official_last_name": "BOGAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "906-483-1500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "700C16002",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portage Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alaric Michael Nielson
• Pieter Nieuwenhuis, PT
• Dana Norman
• Shelby Marie Owens, MD
• Portage Health
• Portage Physician Practices Inc
• Nonie Darlene Riutta, RN
• Melissa Salani, PA
• Taylor Marie Shepeard, PHARMD
• Wendy Stuffle

• Family Medicine Physician in Lake Linden, MI
• Providers in Lake Linden, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2009; 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.