NPIMap

Organization Active NPI

Michigan Health Clinics PC

  • Dermatology Physician
  • Saginaw, MI
National Provider Identifier
1467070508
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MICHIGAN HEALTH CLINICS PC
Practice address
3925 Fortune Blvd
Saginaw, MI 48603-2287
Phone
(989) 341-5078
Fax
(989) 499-7090
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X

Addresses

Primary practice location

3925 Fortune Blvd
Saginaw, MI 48603-2287

Mailing address

3925 Fortune Blvd
Saginaw, MI 48603-2287
Phone (989) 489-2300

Other practice location 1

1115 S Van Dyke Rd Ste 2
Bad Axe, MI 48413-9660
Phone (989) 341-5078

Other practice location 2

4707 McLeod Dr E
Saginaw, MI 48604-2853
Phone (989) 341-5078

Other practice location 3

4674 Hill St
Cass City, MI 48726-1009
Phone (989) 341-5078

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

Locations

3925 Fortune Blvd
Ste 1
Saginaw, MI 48603

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 6

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": "1467070508",
    "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": "989-489-2300",
            "fax_number": "989-499-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 FORTUNE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032287",
            "telephone_number": "989-341-5078",
            "fax_number": "989-499-7090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 S Van Dyke Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bad Axe",
            "state": "MI",
            "postal_code": "484139660",
            "country_code": "US",
            "telephone_number": "989-341-5078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4707 McLeod Dr E",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486042853",
            "country_code": "US",
            "telephone_number": "989-341-5078",
            "fax_number": "989-341-5073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4674 Hill St",
            "address_purpose": "LOCATION",
            "city": "Cass City",
            "state": "MI",
            "postal_code": "487261009",
            "country_code": "US",
            "telephone_number": "989-341-5078",
            "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": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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.