NPIMap

Organization Active NPI

Promed Healthcare Nurse Practitioners

  • Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1487825006
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PROMED HEALTHCARE NURSE PRACTITIONERS
Practice address
5943 Stadium Dr
Ste 1
Kalamazoo, MI 49009-3016
Phone
(269) 552-2836
Fax
(269) 552-2964
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Dr. Ed Millermaier, M.D.
Title
Chief Medical Officer
Phone
(269) 552-2898

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X
Obstetrics & Gynecology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LX0001X

Addresses

Primary practice location

5943 Stadium Dr
Ste 1
Kalamazoo, MI 49009-3016

Mailing address

5943 Stadium Dr
Ste 1
Kalamazoo, MI 49009-3016
Phone (269) 552-2836

Other identifiers 1

IdentifierTypeStateIssuer
0M92480OtherMIMEDICARE GROUP #

National Provider Directory

National Provider Directory
Tax ID family
Promed Healthcare12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

5943 Stadium Dr
Ste 1
Kalamazoo, MI 49009
Phone (269) 552-2836

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1487825006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DR",
            "address_2": "STE 1",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093016",
            "telephone_number": "269-552-2836",
            "fax_number": "269-552-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DR",
            "address_2": "STE 1",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093016",
            "telephone_number": "269-552-2836",
            "fax_number": "269-552-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED HEALTHCARE NURSE PRACTITIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "MILLERMAIER",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "269-552-2898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "0M92480",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.