NPIMap

Organization Active NPI

DLP Marquette Physician Practices Inc

Doing business as Marquette General Family Medicine - Marquette

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
National Provider Identifier
1487902995
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
Legal business name
DLP MARQUETTE PHYSICIAN PRACTICES INC
Doing business as
Marquette General Family Medicine - Marquette
Practice address
1414 W Fair Ave
Ste 36
Marquette, MI 49855-2675
Phone
(906) 225-3864
Fax
(906) 225-3851
NPI assigned
Aug 15, 2012
Last updated
May 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Monica Bowman
Title
President
Phone
(615) 920-7000

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X Primary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1414 W Fair Ave
Ste 36
Marquette, MI 49855-2675

Mailing address

1414 W Fair Ave
Ste 36
Marquette, MI 49855-2675
Phone (906) 225-3864

Other names 1

  • MARQUETTE GENERAL FAMILY MEDICINE - MARQUETTE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL, TX, GA, VA, DC6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20121016000312 MI Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 467 practitioners
33 other NPIs on this enrollment
Practice locations: Marquette, MI; Negaunee, MI; Newberry, MI; Escanaba, MI; Ontonagon, MI; Sault Sainte Marie, MI; Ternary, MI; Manistique, MI…
O20240725001079 FL Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 5 practitioners
Practice locations: Bonita Springs, FL; Orlando, FL; Ormond Beach, FL; Port St Lucie, FL; Tampa, FL
O20240801001201 TX Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 3 practitioners
Practice locations: Houston, TX; San Antonio, TX; Fort Worth, TX
O20240806004425 GA Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 7 practitioners
Practice locations: Suwanee, GA; Sparks, GA; Mableton, GA; Lawrenceville, GA; Decatur, GA; Atlanta, GA
O20240829002671 VA Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 2 practitioners
Practice locations: Richmond, VA; Yorktown, VA
O20240914000136 DC Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Alexandria, VA; Fairfax, VA; Potomac, MD

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory

Locations

5284 Floyd Rd SW
Unit 704
Mableton, GA 30126
Phone (678) 609-8787

1400 W Washington St
Ofc
Marquette, MI 49855

1414 W Fair Ave
Ste 242
Marquette, MI 49855
Phone (844) 537-1036

1414 W Fair Ave
Ste 249
Marquette, MI 49855
Phone (906) 225-3333

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

850 W Baraga Ave
Ste 35
Marquette, MI 49855

Practitioners & affiliated clinicians

Practitioners 496

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.

View all 496

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1487902995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 36",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3864",
            "fax_number": "906-225-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 36",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3864",
            "fax_number": "906-225-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP MARQUETTE PHYSICIAN PRACTICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARQUETTE GENERAL FAMILY MEDICINE - MARQUETTE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARQUETTE GENERAL FAMILY MEDICINE - MARQUETTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.