Northern Michigan Allergy & Asthma Center, P.C.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

AL052216 Issued in MI

Legal business name

NORTHERN MICHIGAN ALLERGY & ASTHMA CENTER, P.C.

Practice address

405 N Division Rd
Suite 4
Petoskey, MI 49770-9045

Phone

(231) 487-6575

Fax

(231) 439-9837

NPI assigned

May 7, 2007

Last updated

Jul 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Julie Marie Linehan

Title

Office Manager

Phone

(231) 487-6575

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1396958500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N DIVISION RD",
            "address_2": "SUITE 4",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709045",
            "telephone_number": "231-487-6575",
            "fax_number": "231-439-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N DIVISION RD",
            "address_2": "SUITE 4",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709045",
            "telephone_number": "231-487-6575",
            "fax_number": "231-439-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MICHIGAN ALLERGY & ASTHMA CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "LINEHAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "231-487-6575",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "AL052216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4091246-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "0302464921",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "030004444",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northern Michigan Medical Management

• Allergy & Immunology Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Allergy & Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.