NPIMap

Organization Active NPI

Mecosta County Medical Center

Doing business as Corewell Health Big Rapids Hospital Professional

  • Surgery Physician
  • Big Rapids, MI
National Provider Identifier
1508146457
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MECOSTA COUNTY MEDICAL CENTER
Doing business as
Corewell Health Big Rapids Hospital Professional
Spectrum Health Big Rapids Hospital
Practice address
705 Oak St
Big Rapids, MI 49307-3107
Phone
(231) 796-7607
Fax
(231) 796-7557
NPI assigned
Aug 24, 2011
Last updated
Aug 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MECOSTA COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Mr. Thomas E Daugherty
Title
Ceo
Phone
(231) 796-8691

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Surgery Physician 208600000X MI Primary

Addresses

Primary practice location

705 Oak St
Big Rapids, MI 49307-3107

Mailing address

100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 2

  • Corewell Health Big Rapids Hospital Professional Doing business as
  • Spectrum Health Big Rapids Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000335 MI Part B Supplier - Clinic/Group Practice 1951215540 Receives reassigned benefits from 190 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Big Rapids, MI; Canadian Lakes, MI; Evart, MI

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Mecosta County General15 organizations share this tax ID, including this one
Part of
Mecosta County General

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 11

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": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1508146457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 OAK ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493073107",
            "telephone_number": "231-796-7607",
            "fax_number": "231-796-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECOSTA COUNTY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MECOSTA COUNTY MEDICAL CENTER",
        "enumeration_date": "2011-08-24",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-796-8691",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Big Rapids Hospital Professional",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Big Rapids Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Big Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.