NPIMap

Organization Active NPI

McLaren Bay Region

  • Family Medicine Physician
  • West Branch, MI
National Provider Identifier
1477846111
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCLAREN BAY REGION
Practice address
2331 Progress St
Suite D
West Branch, MI 48661
Phone
(989) 345-1184
Fax
(989) 345-6944
NPI assigned
May 26, 2011
Last updated
Aug 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Authorized official

Name
Danielle C Jacks Porter
Title
Cfo
Phone
(989) 894-3838

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU
Gerontology Nurse Practitioner 363LG0600X NU
Pediatric Nurse Practitioner 363LP0200X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

2331 Progress St
Suite D
West Branch, MI 48661

Mailing address

2331 Progress St
Suite D, PO Box 340
West Branch, MI 48661-9384
Phone (989) 345-1184

National Provider Directory

National Provider Directory
Tax ID family
Bay Medical Ctr Qme Pro16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

2331 Progress St
Ste D
West Branch, MI 48661
Phone (989) 345-0945

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1477846111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 PROGRESS ST",
            "address_2": "SUITE D, PO BOX 340",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619384",
            "telephone_number": "989-345-1184",
            "fax_number": "989-345-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 PROGRESS ST",
            "address_2": "SUITE D",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "48661",
            "telephone_number": "989-345-1184",
            "fax_number": "989-345-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN BAY REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "JACKS PORTER",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "989-894-3838"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.