NPIMap

Organization Active NPI

Huron Medical Cneter

  • Pediatrics Physician
  • Bad Axe, MI
National Provider Identifier
1396176830
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101015749 Issued in MI
Legal business name
HURON MEDICAL CNETER
Practice address
1080 S Van Dyke Rd
Bad Axe, MI 48413-9635
Phone
(989) 269-7775
Fax
(989) 269-7677
NPI assigned
Dec 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Authorized official

Name
Michael Eric Johnston
Title
President & Ceo
Phone
(989) 803-7127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 5101015749 MI Primary

Addresses

Primary practice location

1080 S Van Dyke Rd
Bad Axe, MI 48413-9635

Mailing address

1080 S Van Dyke Rd
Bad Axe, MI 48413-9635
Phone (989) 269-7775

Other identifiers 1

IdentifierTypeStateIssuer
151899401OtherMINPI

Other names 1

  • McLaren Thumb Region Doing business as

National Provider Directory

National Provider Directory
Tax ID family
McLaren Thumb Region16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1396176830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139635",
            "telephone_number": "989-269-7775",
            "fax_number": "989-269-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139635",
            "telephone_number": "989-269-7775",
            "fax_number": "989-269-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON MEDICAL CNETER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "989-803-7127"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101015749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "151899401",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLaren Thumb Region",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bad Axe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.