NPIMap

Organization Active NPI

Van Buren/Cass District Public Health Department

  • Public Health Dentistry
  • Mattawan, MI
National Provider Identifier
1417385089
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
Legal business name
VAN BUREN/CASS DISTRICT PUBLIC HEALTH DEPARTMENT
Practice address
23200 Red Arrow Hwy
Mattawan, MI 49071-7754
Phone
(269) 621-3143
Fax
(269) 621-2725
NPI assigned
Oct 17, 2013
Last updated
Oct 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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

Authorized official

Name
Mr. Jeffery Elliott
Title
Health Officer/Administrator
Phone
(269) 621-3143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X MI Primary

Addresses

Primary practice location

23200 Red Arrow Hwy
Mattawan, MI 49071-7754

Mailing address

57418 County Road 681
Hartford, MI 49057-9421
Phone (269) 621-3143

National Provider Directory

National Provider Directory
Tax ID family
Van Buren Cass District Public Health Department18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1417385089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57418 COUNTY ROAD 681",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490579421",
            "telephone_number": "269-621-3143",
            "fax_number": "269-621-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23200 RED ARROW HWY",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490717754",
            "telephone_number": "269-621-3143",
            "fax_number": "269-621-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN BUREN/CASS DISTRICT PUBLIC HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-17",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "HEALTH OFFICER/ADMINISTRATOR",
        "authorized_official_telephone_number": "269-621-3143",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattawan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.