NPIMap

Organization Active NPI

20TH Street Clinic PC

  • Family Medicine Physician
  • Battle Creek, MI
National Provider Identifier
1578744918
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101004673 Issued in MI
Legal business name
20TH STREET CLINIC PC
Practice address
105 N 20TH St
Battle Creek, MI 49015-1746
Phone
(269) 969-6010
Fax
(269) 964-8422
NPI assigned
Nov 14, 2007
Last updated
Mar 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Dr. Stephen Fedele, DONPI 1033171699
Title
Owner
Phone
(269) 969-6010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 5101004673 MI Primary

Addresses

Primary practice location

105 N 20TH St
Battle Creek, MI 49015-1746

Mailing address

105 N 20TH St
Battle Creek, MI 49015-1746
Phone (269) 969-6010

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1578744918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N 20TH ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151746",
            "telephone_number": "269-969-6010",
            "fax_number": "269-964-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N 20TH ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151746",
            "telephone_number": "269-969-6010",
            "fax_number": "269-964-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20TH STREET CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "FEDELE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-969-6010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101004673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.