Organization Active NPI

Michigan Spine and Brain Institute PC

  • Neurological Surgery Physician
  • Saginaw, MI
National Provider Identifier
1417291121
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
MICHIGAN SPINE AND BRAIN INSTITUTE PC
Practice address
5400 Mackinaw Rd
Ste 2300
Saginaw, MI 48604-9515
Phone
(989) 753-4000
Fax
(989) 754-4000
NPI assigned
Nov 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Mark AdamsNPI 1427090448
Title
Owner
Phone
(989) 753-4000

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
Neurological Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

5400 Mackinaw Rd
Ste 2300
Saginaw, MI 48604-9515

Mailing address

4009 Orchard Dr
Ste 3003
Midland, MI 48670-9515
Phone (989) 753-4000

Other identifiers 2

IdentifierTypeStateIssuer
669049001OtherMIPTAN
4647680MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Michigan Spine PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4009 Orch Dr
Midland, MI 48670
Phone (989) 753-4000

Practitioners & affiliated clinicians

Practitioners 1

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": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1417291121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 ORCHARD DR",
            "address_2": "STE 3003",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486709515",
            "telephone_number": "989-753-4000",
            "fax_number": "989-754-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 MACKINAW RD",
            "address_2": "STE 2300",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049515",
            "telephone_number": "989-753-4000",
            "fax_number": "989-754-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SPINE AND BRAIN INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-753-4000"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "669049001",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4647680",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.