NPIMap

Organization Active NPI

Branch Pediatric&Adolescent Medicinepc

  • Pediatric Adolescent Medicine Physician
  • Coldwater, MI
National Provider Identifier
1497130132
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
065709 Issued in MI
Legal business name
BRANCH PEDIATRIC&ADOLESCENT MEDICINEPC
Practice address
390 E Chicago St
Coldwater, MI 49036-2062
Phone
(616) 818-9750
NPI assigned
Jul 23, 2015
Last updated
Sep 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Mehalai Arivoli, MDNPI 1346274891
Title
President
Phone
(517) 924-1465

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
Pediatric Adolescent Medicine Physician 2080A0000X 065709 MI Primary

Addresses

Primary practice location

390 E Chicago St
Coldwater, MI 49036-2062

Mailing address

390 E Chicago St
Coldwater, MI 49036-2062
Phone (616) 818-9750

National Provider Directory

National Provider Directory

Locations

390 E Chicago St
Coldwater, MI 49036
Phone (517) 924-1465

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12299/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

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": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1497130132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E CHICAGO ST",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362062",
            "telephone_number": "616-818-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E CHICAGO ST",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362062",
            "telephone_number": "616-818-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH PEDIATRIC&ADOLESCENT MEDICINEPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "ARIVOLI",
        "authorized_official_first_name": "MEHALAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-924-1465",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "065709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.