Active NPI
Pathways
- Family Medicine Physician
- Marquette, MI
National Provider Identifier
1457680357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PATHWAYS
- Practice address
- 200 W Spring St
Marquette, MI 49855-4630 - Phone
- (906) 233-1236
- Fax
- (906) 233-1235
- NPI assigned
- Dec 24, 2009
- Last updated
- Jan 11, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Laura Nelson
- Title
- Credentialing Coordinator
- Phone
- (906) 233-1236
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X | MI |
Addresses
Primary practice location
200 W Spring St
Marquette, MI 49855-4630
Mailing address
200 W Spring St
Marquette, MI 49855-4630
Phone (906) 233-1236
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1724945 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040614000139 | MI | Part B Supplier - Clinic/Group Practice | 4284626391 |
Receives reassigned benefits from 20 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Escanaba, MI; Newberry, MI; Munising, MI; Marquette, MI |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Marquette, MI
- NPI 1487683546
O20040614000139
National Provider Directory
National Provider Directory- Tax ID family
- Pathways Community Mental Health
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatry Physician
- Marquette, MI
- NPI 1346874708
-
- Adolescent and Children Mental Health Clinic/Center
- Marquette, MI
- NPI 1326127416
-
- Clinical Social Worker
- Marquette, MI
- NPI 1497616601
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Munising, MI
- NPI 1508025800
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Newberry, MI
- NPI 1316106610
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Escanaba, MI
- NPI 1558520858
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Psychiatry Physician
- Marquette, MI
- NPI 1447871983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1515628800000",
"number": "1457680357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W SPRING ST",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498554630",
"telephone_number": "906-233-1236",
"fax_number": "906-233-1235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W SPRING ST",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498554630",
"telephone_number": "906-233-1236",
"fax_number": "906-233-1235"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PATHWAYS",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-24",
"last_updated": "2018-01-11",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "906-233-1236"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "MI",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1724945",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marquette, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.