Community Care of Dowagiac, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COMMUNITY CARE OF DOWAGIAC, PLLC

Practice address

57392 M 51 S
Dowagiac, MI 49047-9766

Phone

(269) 462-9587

Fax

(269) 462-9589

NPI assigned

Aug 10, 2021

Last updated

Sep 25, 2023By 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

Kathleen Basha, PA-CNPI 1083932685

Title

Provider

Phone

(269) 462-9587

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Community Care of Dowagiac Other name

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24642/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• Kathleen Basha, PA-C

  • Medical Physician Assistant
  • Dowagiac, MI
  • NPI 1083932685
  Authorized official Same address or phone
• Son H Phung, MD

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1174550172
  NPD (past)

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1427723675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490470364",
            "telephone_number": "269-462-9587",
            "fax_number": "269-462-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57392 M 51 S",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490479766",
            "telephone_number": "269-462-9587",
            "fax_number": "269-462-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE OF DOWAGIAC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-10",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "BASHA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "269-462-9587",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74575",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4837343",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care of Dowagiac",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Boonchoo Chang, M.D.
• Shanta Lynn Clark, P.A.-C
• Michelle Marie Cockey, FNP
• Delphine Colar, DO
• Comfort Living Home L.L.C. #3
• Heather Cook-Sinden, NP
• Matthew Vincent Cripe, DDS
• Olivia Hock Crofoot
• Susan Diane Curtis, MSPT
• D&a Dissolving, Inc.

• Internal Medicine Physician in Dowagiac, MI
• Providers in Dowagiac, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.