NPIMap

Organization Active NPI

Huron Medical Center PC

  • Hematology & Oncology Physician
  • Port Huron, MI
National Provider Identifier
1447277496
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301051703 Issued in MI
Legal business name
HURON MEDICAL CENTER PC
Practice address
1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone
(810) 982-5200
Fax
(810) 982-9776
NPI assigned
Jul 16, 2006
Last updated
Mar 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Mrs. Theresa Lynn Stiles
Title
Office Manager/Biller
Phone
(810) 982-5200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 4301051703 MI Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

1221 Pine Grove Ave
Port Huron, MI 48060-3511

Mailing address

1231 Pine Grove Ave Ste 2F
Port Huron, MI 48060-3500
Phone (810) 982-5200

Other identifiers 5

IdentifierTypeStateIssuer
110G41039OtherMIBCBSM HANNA
P115104OtherMIBCN HANNA
4397059MedicaidMI
3165470MedicaidMI
P78652OtherMIBCN ALSAWAH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060803000493 MI Part B Supplier - Clinic/Group Practice 0648283929 Receives reassigned benefits from 10 practitioners
Practice locations: Port Huron, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0915078Huron Medical Center of Port Huron PC1221 Pine Grove Ave, 2ND Floor, Port Huron, MI 48060ComplianceJun 10, 2027

National Provider Directory

National Provider Directory

Locations

1214 Richardson St
Port Huron, MI 48060
Phone (810) 982-5200

1221 Pine Grove Ave
Fl 2
Port Huron, MI 48060

1231 Pine Grove Ave
Ste 2F
Port Huron, MI 48060
Phone (810) 982-5200

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1447277496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE STE 2F",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-982-5200",
            "fax_number": "810-982-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-982-5200",
            "fax_number": "810-982-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER/BILLER",
        "authorized_official_telephone_number": "810-982-5200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301051703",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM HANNA",
            "identifier": "110G41039",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN HANNA",
            "identifier": "P115104",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4397059",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3165470",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN ALSAWAH",
            "identifier": "P78652",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.