FMG North Street West Michigan LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG NORTH STREET WEST MICHIGAN LLC

Doing business as

Tendercare Tawas City

Practice address

400 North St W
Tawas City, MI 48763-9161

Phone

(989) 362-8645

Fax

(989) 362-4462

NPI assigned

Dec 18, 2014

Organization subpart

No

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

Authorized official

Name

David Keating

Title

Authorized Official

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Tendercare Tawas City Doing business as

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1396143665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NORTH ST W",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639161",
            "telephone_number": "989-362-8645",
            "fax_number": "989-362-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH ST W",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639161",
            "telephone_number": "989-362-8645",
            "fax_number": "989-362-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG NORTH STREET WEST MICHIGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tendercare Tawas City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Thomas Fahy, DO
• Family Foot and Ankle Center, P.C.
• Nicole Farrand, OTRL
• Mary Anne Filka, RN
• Dwight Fiske, PA-C, RN, AEMT
• Chelsea Gabrielle Fournier, LPTA
• Geri Lyn Fowler, RN, QIDP, QMHP
• Mark A Gallagher, D.O.
• Cathleen M Garner
• Jorden Gary, OTRL

• Skilled Nursing Facility in Tawas City, MI
• Providers in Tawas City, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.