NPIMap

Organization Active NPI

Michigan Health Clinics PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Saginaw, MI
National Provider Identifier
1417575556
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
MICHIGAN HEALTH CLINICS PC
Practice address
4707 McLeod Dr E
Saginaw, MI 48604-2853
Phone
(989) 341-5078
Fax
(989) 341-5073
NPI assigned
Jul 6, 2020
Last updated
Mar 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MICHIGAN HEALTH CLINICS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
David L. Stockman, MDNPI 1407086424
Title
President
Phone
(989) 341-5078

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
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

4707 McLeod Dr E
Saginaw, MI 48604-2853

Mailing address

3925 Fortune Blvd
Saginaw, MI 48603-2287
Phone (989) 459-2300

Other practice location 1

3925 Fortune Blvd
Saginaw, MI 48603-2287
Phone (989) 459-2300

Other names 1

  • Covenant Pathology Associates PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405000837 MI Part B Supplier - Clinic/Group Practice 5991798183 Receives reassigned benefits from 7 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bad Axe, MI; Cass City, MI; Saginaw, MI

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Covenant Pathology Assoc PC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1417575556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 FORTUNE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032287",
            "telephone_number": "989-459-2300",
            "fax_number": "989-499-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 MCLEOD DR E",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042853",
            "telephone_number": "989-341-5078",
            "fax_number": "989-341-5073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3925 Fortune Blvd",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486032287",
            "country_code": "US",
            "telephone_number": "989-459-2300",
            "fax_number": "989-499-7090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHIGAN HEALTH CLINICS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN HEALTH CLINICS PC",
        "enumeration_date": "2020-07-06",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "STOCKMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-341-5078",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Pathology Associates PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 29, 2024; 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.