McLaren Bay Region
Organization Active NPI Internal Medicine Physician · West Branch, MI
NPI 1649560467 · NPPES record last updated Aug 7, 2018
Key facts
- NPI
- 1649560467
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- MCLAREN BAY REGION
- Practice address
- 611 Court St
West Branch, MI 48661 - Phone
- (989) 345-7000
- Fax
- (989) 345-7479
- NPI assigned
- Apr 13, 2011
- Organization subpart
- No
Authorized official
- Name
- Danielle C Jacks Porter
- Title
- Cfo
- Phone
- (989) 894-3838
Other NPIs on the same Medicare enrollment 5
Member organizations 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040213000277 | MI | Part B Supplier - Clinic/Group Practice | 5597659011 |
Receives reassigned benefits from 268 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bay City, MI; Essexville, MI; Gladwin, MI; Pigeon, MI; Sterling, MI; Bad Axe, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | |||
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
611 Court St
West Branch, MI 48661
Mailing address
1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3000
Other providers in West Branch, MI
- Ragan Abigayle McGregor
- Jeffery Patrick Scott McIntosh
- Darla McKelvey
- McLaren Bay Region
- McLaren Bay Region
- McLaren Bay Region
- McLaren Central Michigan
- McLaren Medical Group
- McLaren Primary Care
- McLaren Primary Care
All providers in West Branch, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.