Active NPI
Aspirus Keweenaw
- General Practice Physician
- Houghton, MI
National Provider Identifier
1508001629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- ASPIRUS KEWEENAW
- Practice address
- 900 Memorial Drive
Houghton, MI 49931 - Phone
- (906) 483-0679
- Fax
- (906) 483-0686
- NPI assigned
- Dec 3, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lori Peck
- Title
- VP Revenue Cycle
- Phone
- (715) 847-2988
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
900 Memorial Drive
Houghton, MI 49931
Mailing address
205 Osceola Street
Laurium, MI 49913-2134
Phone (906) 337-6560
Other names 1
- Aspirus Keweenaw FastCare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040211000763 | MI | Part B Supplier - Clinic/Group Practice | 8123912011 |
Receives reassigned benefits from 210 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Houghton, MI; Ontonagon, MI; Laurium, MI; Lanse, MI; Lake Linden, MI; Calumet, MI |
Other NPIs on the same Medicare enrollment 9
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228262400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620086400000",
"number": "1508001629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 OSCEOLA STREET",
"city": "LAURIUM",
"state": "MI",
"postal_code": "499132134",
"telephone_number": "906-337-6560",
"fax_number": "906-337-6562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MEMORIAL DRIVE",
"city": "HOUGHTON",
"state": "MI",
"postal_code": "49931",
"telephone_number": "906-483-0679",
"fax_number": "906-483-0686"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ASPIRUS KEWEENAW",
"organizational_subpart": "NO",
"enumeration_date": "2008-12-03",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A",
"authorized_official_last_name": "PECK",
"authorized_official_first_name": "LORI",
"authorized_official_title_or_position": "VP REVENUE CYCLE",
"authorized_official_telephone_number": "715-847-2988"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Aspirus Keweenaw FastCare",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Aspirus Keweenaw FastCare",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Houghton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.