Organization Active NPI

Other Office

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1396798682
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OTHER OFFICE
Practice address
3955 US 31 S
Traverse City, MI 49684-4495
Phone
(231) 935-0500
Fax
(231) 935-0501
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Peter W Springsteen, MDNPI 1265438790
Title
President
Phone
(231) 929-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3955 US 31 S
Traverse City, MI 49684-4495

Mailing address

3074 N US 31 S
Traverse City, MI 49684-4533
Phone (231) 929-1234

Other names 1

  • Affordable Basic Care Doing business as

National Provider Directory

National Provider Directory

Locations

3955 US 31 S
Traverse City, MI 49684
Phone (231) 933-1810

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396798682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 N US 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844533",
            "telephone_number": "231-929-1234",
            "fax_number": "231-935-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 US 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844495",
            "telephone_number": "231-935-0500",
            "fax_number": "231-935-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTHER OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPRINGSTEEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-929-1234",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Basic Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.