NPIMap

Organization Active NPI

Dickinson County Healthcare System

  • Family Medicine Physician
  • Iron Mountain, MI
National Provider Identifier
1417411760
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DICKINSON COUNTY HEALTHCARE SYSTEM
Practice address
1711 S Stephenson Ave Ste 205
Iron Mountain, MI 49801-3649
Phone
(906) 774-1313
NPI assigned
Jan 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Authorized official

Name
Alicia R Henderson
Title
Physician Billing Supervisor
Phone
(906) 774-1313

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1711 S Stephenson Ave Ste 205
Iron Mountain, MI 49801-3649

Mailing address

PO Box 549
Iron Mountain, MI 49801-0549

Other names 1

  • Dickinson Family Practice - Main Campus Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dickinson County System17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549584000000",
    "number": "1417411760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498010549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 205",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013649",
            "telephone_number": "906-774-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKINSON COUNTY HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-02-08",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN BILLING SUPERVISOR",
        "authorized_official_telephone_number": "906-774-1313"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dickinson Family Practice - Main Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.