Organization Active NPI

Allegan Internal Medicine, P. C

  • Internal Medicine Physician
  • Allegan, MI
National Provider Identifier
1508813114
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALLEGAN INTERNAL MEDICINE, P. C
Doing business as
Thomas Street Clinic
Practice address
305 Thomas St
Allegan, MI 49010-9158
Phone
(269) 673-2179
Fax
(269) 673-6992
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Authorized official

Name
Laurie L Hildebrand
Title
Office Manager/Billing
Phone
(269) 673-2179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

305 Thomas St
Allegan, MI 49010-9158

Mailing address

305 Thomas St
Allegan, MI 49010-9158
Phone (269) 673-2179

Other identifiers 1

IdentifierTypeStateIssuer
110Z310760OtherMIBLUE CROSS PIN

Other names 2

  • Thomas Street Clinic Doing business as
  • Allegan Internal Medicine, P. C Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060616000040 MI Part B Supplier - Clinic/Group Practice 4183636954 Receives reassigned benefits from 2 practitioners
Practice locations: Allegan, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0869871Thomas Street Clinic PC305 Thomas Street, Allegan, MI 49010Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1508813114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 THOMAS ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109158",
            "telephone_number": "269-673-2179",
            "fax_number": "269-673-6992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 THOMAS ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109158",
            "telephone_number": "269-673-2179",
            "fax_number": "269-673-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGAN INTERNAL MEDICINE, P. C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A",
        "authorized_official_last_name": "HILDEBRAND",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER/BILLING",
        "authorized_official_telephone_number": "269-673-2179"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "110Z310760",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas Street Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thomas Street Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allegan Internal Medicine, P. C",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Allegan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.