Geriatric Physician Staffing PC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4301051573 Issued in MI

Legal business name

GERIATRIC PHYSICIAN STAFFING PC

Practice address

124 W Fourth St
Suttons Bay, MI 49682-9733

Phone

(231) 271-1200

Fax

(231) 271-5959

NPI assigned

Jul 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Phillip W Siemer, MD

Title

Physician

Phone

(231) 271-5990

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Kathryn A Snow-McCaffrey, APRN MSN GNP

  • Gerontology Nurse Practitioner
  • Indian River, MI
  • NPI 1487625174
  NPD (past)
• Kelly Ann O'Sullivan, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Vancouver, WA
  • NPI 1750332474
  NPD (past)

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1558616144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N SETTERBO RD",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496829391",
            "telephone_number": "231-271-5990",
            "fax_number": "231-271-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W FOURTH ST",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496829733",
            "telephone_number": "231-271-1200",
            "fax_number": "231-271-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PHYSICIAN STAFFING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "SIEMER",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "231-271-5990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301051573",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "4301051573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588612972",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frances Eckerson, LPCC, M.ED.
• Christopher Ryan Eggleston
• Emily S. Kohler, LMSW PLLC
• FMG West Fourth Street Michigan LLC
• Freedom in Motion Therapy, LLC
• Grand Traverse Band of Ottawa and Chippewa Indians
• Morgan Green, DPT
• Thomas Guy Halanski, R.PH.
• Margaret Ann Hall, MSN, RN, FNP-BC
• Steven David Hall, DDS

• Skilled Nursing Facility in Suttons Bay, MI
• Providers in Suttons Bay, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.