Organization Active NPI

Quick Care Family Medical Center PC

  • General Practice Physician
  • Petoskey, MI
National Provider Identifier
1518145309
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
GL053321 Issued in MI
Legal business name
QUICK CARE FAMILY MEDICAL CENTER PC
Practice address
116 W Mitchell St
Petoskey, MI 49770-2324
Phone
(231) 348-2828
Fax
(231) 348-9609
NPI assigned
Feb 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Dr. Gustav J Lo, M.D.
Title
Medical Director
Phone
(231) 348-2828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X GL053321 MI Primary

Addresses

Primary practice location

116 W Mitchell St
Petoskey, MI 49770-2324

Mailing address

116 W Mitchell St
Petoskey, MI 49770-2324
Phone (231) 348-2828

Other identifiers 1

IdentifierTypeStateIssuer
5176052MedicaidMI

National Provider Directory

National Provider Directory

Locations

1249 S M 75
Boyne City, MI 49712
Phone (231) 582-1515

116 W Mitchell St
Ste 1
Petoskey, MI 49770
Phone (231) 348-2828

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": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1518145309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W MITCHELL ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702324",
            "telephone_number": "231-348-2828",
            "fax_number": "231-348-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W MITCHELL ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702324",
            "telephone_number": "231-348-2828",
            "fax_number": "231-348-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUICK CARE FAMILY MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "GUSTAV",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "231-348-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "GL053321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5176052",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.