Organization Active NPI

Art of Medicine Personalized PLLC

  • Family Medicine Physician
  • Petoskey, MI
National Provider Identifier
1407527658
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ART OF MEDICINE PERSONALIZED PLLC
Practice address
405 N Division Rd Ste 4
Petoskey, MI 49770-9046
Phone
(231) 622-6570
NPI assigned
Sep 27, 2021
Last updated
Mar 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Wendy H Walker, MDNPI 1053379834
Title
Owner/Member
Phone
(231) 330-6417

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 Physician 207Q00000X NU Primary

Addresses

Primary practice location

405 N Division Rd Ste 4
Petoskey, MI 49770-9046

Mailing address

405 N Division Rd Ste 4
Petoskey, MI 49770-9046
Phone (231) 373-8806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220407002540 MI Part B Supplier - Clinic/Group Practice 4486040003 Receives reassigned benefits from 2 practitioners
Practice locations: Petoskey, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2241843Art of Medicine Personalized, PLLC405 N Division Road Suite 4, Petoskey, MI 49770Provider-performed microscopyNov 1, 2027

National Provider Directory

National Provider Directory

Locations

405 N Division Rd
Ste 4
Petoskey, MI 49770
Phone (231) 373-8806

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1407527658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N DIVISION RD STE 4",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709046",
            "telephone_number": "231-373-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N DIVISION RD STE 4",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709046",
            "telephone_number": "231-622-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ART OF MEDICINE PERSONALIZED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "231-330-6417",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.