NPIMap

Organization Active NPI

Little River Band of Ottawa Indians

  • Federally Qualified Health Center (FQHC)
  • Manistee, MI
National Provider Identifier
1467131409
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LITTLE RIVER BAND OF OTTAWA INDIANS
Practice address
2840 Orchard Hwy Ste 2
Manistee, MI 49660-9781
Phone
(231) 398-6852
NPI assigned
Jul 17, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Dr. Daryl B WeverNPI 1386807212
Title
Director/Physician
Phone
(231) 398-6852

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

2840 Orchard Hwy Ste 2
Manistee, MI 49660-9781

Mailing address

2840 Orchard Hwy Ste 2
Manistee, MI 49660-9781
Phone (231) 398-6852

National Provider Directory

National Provider Directory
Tax ID family
Little River Band of Ottawa Indians6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

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.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1467131409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 ORCHARD HWY STE 2",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609781",
            "telephone_number": "231-398-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 ORCHARD HWY STE 2",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609781",
            "telephone_number": "231-398-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVER BAND OF OTTAWA INDIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "WEVER",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR/PHYSICIAN",
        "authorized_official_telephone_number": "231-398-6852",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.