NPIMap

Organization Active NPI

Community Health Center of Branch County

Doing business as CHC Cardinal Connect

  • Pediatric Adolescent Medicine Physician
  • Coldwater, MI
National Provider Identifier
1619304458
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
Doing business as
CHC Cardinal Connect
Practice address
275 N Fremont St
Coldwater, MI 49036-1206
Phone
(517) 279-5295
NPI assigned
Oct 10, 2013
Last updated
Nov 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Authorized official

Name
Randall Degroot
Title
President/Ceo
Phone
(517) 279-5489

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X NU Primary

Addresses

Primary practice location

275 N Fremont St
Coldwater, MI 49036-1206

Mailing address

274 E Chicago St
Coldwater, MI 49036-2041
Phone (517) 279-5400

Other practice location 1

175 Green St
Coldwater, MI 49036-1002
Phone (517) 279-5459

Other names 1

  • CHC Cardinal Connect Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000671 MI Part B Supplier - Clinic/Group Practice 9335037514 Receives reassigned benefits from 162 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coldwater, MI; Union City, MI; Quincy, MI; Litchfield, MI; Bronson, MI

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory

Locations

195 Division St
Bronson, MI 49028
Phone (517) 369-2506

197 Division St
Bronson, MI 49028
Phone (517) 369-2506

721 E Chicago St
Bronson, MI 49028
Phone (517) 369-2506

175 Green St
Coldwater, MI 49036
Phone (517) 279-5459

23 N Hanchett St
Coldwater, MI 49036
Phone (517) 278-3412

320 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5050

358 E Chicago St
Ste 202
Coldwater, MI 49036
Phone (517) 279-5252

358 E Chicago St
Ste C
Coldwater, MI 49036
Phone (517) 279-5252

360 E Chicago St
Ste 106
Coldwater, MI 49036
Phone (517) 279-5049

370 E Chicago St
Ste 700
Coldwater, MI 49036
Phone (517) 279-5099

413 N Chicago St
Litchfield, MI 49252
Phone (517) 542-2357

Practitioners & affiliated clinicians

Practitioners 140

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 140

NPI Registry JSON

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541721600000",
    "number": "1619304458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 E CHICAGO ST",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362041",
            "telephone_number": "517-279-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 N FREMONT ST",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361206",
            "telephone_number": "517-279-5295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Green St",
            "address_purpose": "LOCATION",
            "city": "Coldwater",
            "state": "MI",
            "postal_code": "490361002",
            "country_code": "US",
            "telephone_number": "517-279-5459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF BRANCH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2018-11-09",
        "status": "A",
        "authorized_official_last_name": "DEGROOT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "517-279-5489"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHC Cardinal Connect",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHC Cardinal Connect",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coldwater, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.