NPIMap

Organization Active NPI

Upper Michigan Cardiovascular Associates, PC

  • Cardiovascular Disease Physician
  • Marquette, MI
National Provider Identifier
1649214099
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
UPPER MICHIGAN CARDIOVASCULAR ASSOCIATES, PC
Practice address
1414 West Fair Ave
Suite 334
Marquette, MI 49855
Phone
(906) 225-3870
Fax
(906) 225-4861
NPI assigned
Jun 16, 2006
Last updated
Oct 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Thomas Dale Legalley, MDNPI 1255375614
Title
President
Phone
(906) 225-3870

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU

Addresses

Primary practice location

1414 West Fair Ave
Suite 334
Marquette, MI 49855

Mailing address

1414 West Fair Ave
Suite 334
Marquette, MI 49855
Phone (906) 225-3870

Other identifiers 1

IdentifierTypeStateIssuer
700E210530OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

504 Campus Dr
Hancock, MI 49930
Phone (906) 482-9551

Practitioners & affiliated clinicians

Practitioners 11

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": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1649214099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 WEST FAIR AVE",
            "address_2": "SUITE 334",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3870",
            "fax_number": "906-225-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 WEST FAIR AVE",
            "address_2": "SUITE 334",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3870",
            "fax_number": "906-225-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER MICHIGAN CARDIOVASCULAR ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "LEGALLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-225-3870",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "700E210530",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.