Traverse Health Clinic and Coalition

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

TRAVERSE HEALTH CLINIC AND COALITION

Doing business as

Traverse Health Clinic

Practice address

105 Hall St
Traverse City, MI 49684-2288

Phone

(231) 935-4394

Fax

(231) 935-3696

NPI assigned

Dec 10, 2015

Last updated

Jan 28, 2016By 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

Arlene J Brennan, MHSA

Title

Ceo

Phone

(231) 935-0351

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Traverse Health Clinic Doing business as

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1417322884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 LOGAN VALLEY RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844772",
            "telephone_number": "231-935-0799",
            "fax_number": "231-935-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HALL ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842288",
            "telephone_number": "231-935-4394",
            "fax_number": "231-935-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVERSE HEALTH CLINIC AND COALITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-935-0351",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669441457",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265517494",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Traverse Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Traverse City Uscg Phcy
• Traverse Dental Associates, PLLC
• Traverse Geriatric Village, Inc (bortz health care of traverse)
• Traverse Health Clinic and Coalition (Traverse Health Clinic Pharmacy)
• Traverse Health Clinic and Coalition (Traverse Health Clinic)
• Traverse Health Clinic and Coalition (Traverse Health Clinic)
• Traverse Health Clinic and Coalition (Mobile Medical Van)
• Traverse Observation Physician Services PC
• Traverse Victorian Assisted Living, LLC
• Olivia Anne Travis, O.D.

• Federally Qualified Health Center (FQHC) in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Federally Qualified Health Center (FQHC) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.