Internal Medicine of Northern Michigan PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE OF NORTHERN MICHIGAN PLLC

Practice address

560 W Mitchell St
Suite 300
Petoskey, MI 49770-2275

Phone

(231) 487-2460

Fax

(231) 487-6596

NPI assigned

Mar 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert E Farrell

Title

Practice Administrator

Phone

(231) 487-2460

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Internal Medicine of Northern Michigan Laboratory

  • Clinical Medical Laboratory
  • Petoskey, MI
  • NPI 1801150453
  NPPES parent name

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313539200000",
    "number": "1467420901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "SUITE 300",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702275",
            "telephone_number": "231-487-2460",
            "fax_number": "231-487-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "SUITE 300",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702275",
            "telephone_number": "231-487-2460",
            "fax_number": "231-487-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF NORTHERN MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2011-08-17",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "231-487-2460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIRSP",
            "identifier": "99111316",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF8034",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "619706",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BCBS",
            "identifier": "110B410170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH GROUP ID",
            "identifier": "20146",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Ann Ingalls, DPT
• Kelly Scolnick Ingleson, L.P.C
• Integrative Cardiovascular Health & Wellness
• Integrative Specialty Care of Northern Michigan
• Internal Medicine of Northern Michigan Laboratory
• Irb Medical Equipment LLC
• Heather Renee Irish, LPC
• Timothy J Ismond, D.O.
• Amy Jackson
• Terry S Jackson, D.O.

• Internal Medicine Physician in Petoskey, MI
• Providers in Petoskey, 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 Aug 17, 2011; 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.