Pace of Southwest Michigan Inc

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

PACE OF SOUTHWEST MICHIGAN INC

Practice address

2900 Lakeview Ave
Saint Joseph, MI 49085-2379

Phone

(269) 408-4322

Fax

(269) 408-4340

NPI assigned

Jan 14, 2013

Organization subpart

No

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

Authorized official

Name

Therese Saggau

Title

Executive Director

Phone

(269) 408-4322

Specialties & licenses 1

Addresses

Other identifiers 2

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

CLIA laboratory certificates

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1568709392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LAKEVIEW AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852379",
            "telephone_number": "269-408-4322",
            "fax_number": "269-408-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LAKEVIEW AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852379",
            "telephone_number": "269-408-4322",
            "fax_number": "269-408-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACE OF SOUTHWEST MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "SAGGAU",
        "authorized_official_first_name": "THERESE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "269-408-4322"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID BILLING AGENT ID",
            "identifier": "2332863",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2331543",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Tayman Orrison, MSPT
• Marsha Osborn
• Shelly Ott
• Mark David Ottmar, MD
• Danica Overton, PSYD
• Courtney Chilton Palguta, D.O.
• Laura Pallo, CCC-SLP
• Shelley Palma, CMA
• Edmund B Paloyan, M.D.
• Shreya Palyekar

• PACE Provider Organization in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• PACE Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.