NPIMap

Organization Active NPI

Allegan County Community Mental Health Services

  • Primary Care Clinic/Center
  • Allegan, MI
National Provider Identifier
1528570322
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ALLEGAN COUNTY COMMUNITY MENTAL HEALTH SERVICES
Practice address
3285 122ND Ave
Allegan, MI 49010-9511
Phone
(269) 673-6617
Fax
(269) 673-2738
NPI assigned
Nov 2, 2017
Last updated
Nov 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Authorized official

Name
Lynn Yetman
Title
Reimbursement Coordinator
Phone
(269) 673-6617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

3285 122ND Ave
Allegan, MI 49010-9511

Mailing address

PO Box 130
Allegan, MI 49010-0130
Phone (269) 673-6617

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421001240 MI Part B Supplier - Clinic/Group Practice 1153317607 Receives reassigned benefits from 32 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Allegan, MI

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509580800000",
    "number": "1528570322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490100130",
            "telephone_number": "269-673-6617",
            "fax_number": "269-686-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 122ND AVE",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109511",
            "telephone_number": "269-673-6617",
            "fax_number": "269-673-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGAN COUNTY COMMUNITY MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A",
        "authorized_official_last_name": "YETMAN",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "REIMBURSEMENT COORDINATOR",
        "authorized_official_telephone_number": "269-673-6617"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 2, 2017; 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.