Mid Michigan Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301071087 Issued in MI

Legal business name

MID MICHIGAN MEDICINE PC

Practice address

1070 E Caro Rd
Caro, MI 48723

Phone

(989) 672-2500

NPI assigned

May 22, 2006

Last updated

Mar 30, 2021By 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

Farrukh Anwar, MDNPI 1144268947

Title

Owner

Phone

(989) 672-2500

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: sfarrukh1248@direct.covenanthealthcare.com

Practitioners 5

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.

• Farrukh Anwar, MD

  • Internal Medicine Physician
  • Caro, MI
  • NPI 1144268947
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Dinsmoore, MSN, FNP-BC

  • Family Nurse Practitioner
  • Caro, MI
  • NPI 1023592516
  Medicare reassignment Care Compare group NPD
• Shahana Farrukh, MD

  • Internal Medicine Physician
  • Caro, MI
  • NPI 1396790275
  Medicare reassignment Care Compare group NPD
• Steven Allen Holman, AGNP

  • Gerontology Nurse Practitioner
  • Caro, MI
  • NPI 1851718399
  Medicare reassignment NPD
• Sayyid S Raza, MD

  • Internal Medicine Physician
  • Bay City, MI
  • NPI 1336176486
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1447205307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 E CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487231217",
            "telephone_number": "989-672-2500",
            "fax_number": "989-672-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 E CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "48723",
            "telephone_number": "989-672-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MICHIGAN MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "ANWAR",
        "authorized_official_first_name": "FARRUKH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-672-2500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301071087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4803971",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4803990",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfarrukh1248@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "1070 E CARO RD",
            "city": "Caro",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Mellendorf
• Vickie L. Merchant, MA, LPC
• Michelle's House
• Michigan Family Physicians PLLC
• Mid Michigan Advanced Imaging Services LLC
• Mid Michigan Pain Management PLLC
• Ashley Marie Migut, LLMSW
• Barbara Lynne Millerov, LMSW
• Michael Scott Misko, DDS
• Jodi Mitchell, LMSW

• Internal Medicine Physician in Caro, MI
• Providers in Caro, 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 Mar 30, 2021; 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.