Active NPI
Bay Area Family Care of Traverse City PLC
- Family Medicine Physician
- Traverse City, MI
National Provider Identifier
1407858798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101009568
- Legal business name
- BAY AREA FAMILY CARE OF TRAVERSE CITY PLC
- Practice address
- 906 Business Park Dr
Traverse City, MI 49686-8683 - Phone
- (231) 935-8755
- NPI assigned
- Jun 1, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sally Miller, DO
- Title
- Partner
- Phone
- (231) 935-8755
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101009568 | MI | Primary |
Addresses
Primary practice location
906 Business Park Dr
Traverse City, MI 49686-8683
Mailing address
PO Box 3318
Grand Rapids, MI 49501-3318
Phone (800) 968-6866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC7393 | Other | MI | RAIL ROAD GROUP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
906 Business Park Dr
Traverse City, MI 49686
Phone (231) 933-6600
1899 Dracka Rd
Ste 100
Traverse City, MI 49685
Phone (231) 946-2999
550 Munson Ave
Ste 101
Traverse City, MI 49686
Phone (231) 935-8750
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Traverse City, MI
- NPI 1760702161
-
- Family Medicine Physician
- Traverse City, MI
- NPI 1255341046
-
- Internal Medicine Physician
- Traverse City, MI
- NPI 1023351731
-
- Internal Medicine Physician
- Traverse City, MI
- NPI 1194779843
-
- Family Nurse Practitioner
- Traverse City, MI
- NPI 1124720958
-
- Family Medicine Physician
- Mackinac Island, MI
- NPI 1326156928
-
- Family Medicine Physician
- Traverse City, MI
- NPI 1972680411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208995200000",
"number": "1407858798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3318",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495013318",
"telephone_number": "800-968-6866",
"fax_number": "616-532-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 BUSINESS PARK DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496868683",
"telephone_number": "231-935-8755"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAY AREA FAMILY CARE OF TRAVERSE CITY PLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-01",
"last_updated": "2008-04-24",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "SALLY",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "231-935-8755",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "MI",
"license": "5101009568",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD GROUP NUMBER",
"identifier": "DC7393",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
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 Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.