NPIMap

Organization Active NPI

CHS Health Services

Doing business as Four Winds Casino Resort

  • General Practice Physician
  • New Buffalo, MI
National Provider Identifier
1629390950
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CHS HEALTH SERVICES
Doing business as
Four Winds Casino Resort
Practice address
11111 Wilson Rd
New Buffalo, MI 49117-8888
Phone
(269) 926-5259
Fax
(269) 926-5475
NPI assigned
Mar 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Authorized official

Name
Mr. Stuart Clark
Title
Executive VP
Phone
(703) 760-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

11111 Wilson Rd
New Buffalo, MI 49117-8888

Mailing address

5500 Maryland Way
Ste 400
Brentwood, TN 37027-4948

Other names 1

  • Four Winds Casino Resort Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Google Wellness Center 32118 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

11111 Wilson Rd
New Buffalo, MI 49117
Phone (269) 296-5259

NPI Registry JSON

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

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467849600000",
    "number": "1629390950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 WILSON RD",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491178888",
            "telephone_number": "269-926-5259",
            "fax_number": "269-926-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-01",
        "last_updated": "2016-07-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "703-760-0700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Winds Casino Resort",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Buffalo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.