NPIMap

Organization Active NPI

Wexford Medical Group

Doing business as Great Lakes Family Care

  • Family Medicine Physician
  • McBain, MI
National Provider Identifier
1508950767
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WEXFORD MEDICAL GROUP
Doing business as
Great Lakes Family Care
Practice address
117 N Roland St
MC Bain, MI 49657-9683
Phone
(231) 825-2643
Fax
(231) 825-0161
NPI assigned
Oct 3, 2006
Last updated
Feb 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Michael Zdorodwski
Title
Administrator
Phone
(231) 876-6730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

117 N Roland St
MC Bain, MI 49657-9683

Mailing address

520 Cobb St
Cadillac, MI 49601-2588
Phone (231) 775-6521

Other names 1

  • GREAT LAKES FAMILY CARE Doing business as

National Provider Directory

National Provider Directory

Locations

117 N Roland St
Mc Bain, MI 49657
Phone (231) 825-2643

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1508950767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-775-6521",
            "fax_number": "231-876-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N ROLAND ST",
            "city": "MC BAIN",
            "state": "MI",
            "postal_code": "496579683",
            "telephone_number": "231-825-2643",
            "fax_number": "231-825-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEXFORD MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "ZDORODWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "231-876-6730"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT LAKES FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McBain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.