Shoreline Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101013736 Issued in MI

Legal business name

SHORELINE FAMILY MEDICINE PC

Practice address

5933 Grand Haven Rd
Muskegon, MI 49441-6011

Phone

(231) 799-3300

Fax

(231) 799-3322

NPI assigned

Jan 31, 2007

Last updated

May 5, 2008By 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

Matthew N. Powell, D.O.NPI 1154316222

Title

Physician

Phone

(231) 780-3300

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JCJCCA

Practitioners 2

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.

• Matthew Neil Powell, D.O.

  • Family Medicine Physician
  • Muskegon, MI
  • NPI 1154316222
  Medicare reassignment NPD Authorized official
• Michelle J Bray, FNP-C

  • Primary Care Nurse Practitioner
  • Norton Shores, MI
  • NPI 1225540065
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1417094459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5933 GRAND HAVEN RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494416011",
            "telephone_number": "231-799-3300",
            "fax_number": "231-799-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5933 GRAND HAVEN RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494416011",
            "telephone_number": "231-799-3300",
            "fax_number": "231-799-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "231-780-3300",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5610080",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4309931",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shoreline ASC, LLC (Shoreline Vision Surgical Center)
• Shoreline Consultation Services
• Shoreline Counseling LLC
• Shoreline Dental Associates, P.C.
• Shoreline ENT PLC
• Shoreline Gastroenterology PC
• Shoreline Hearing Center LLC
• Shoreline Neurosurgical Consulting, PLC
• Shoreline Ophthalmology, PLLC
• Shoreline Ophthalmology, PLLC (Shoreline Optical)

• Family Medicine Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.

Verify at the official NPI Registry.