NPIMap

Organization Active NPI

Wattles Park Family Practice PC

  • Family Medicine Physician
  • Battle Creek, MI
National Provider Identifier
1659512705
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301083010 Issued in MI
Legal business name
WATTLES PARK FAMILY PRACTICE PC
Practice address
1125 Michigan Ave E
Battle Creek, MI 49014-6832
Phone
(269) 969-6291
Fax
(269) 969-6085
NPI assigned
Mar 19, 2009
Last updated
Jun 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Authorized official

Name
Dr. Mark R Henry, M.D.NPI 1164462354
Title
Partner
Phone
(269) 969-6291

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 4301083010 MI Primary

Addresses

Primary practice location

1125 Michigan Ave E
Battle Creek, MI 49014-6832

Mailing address

1125 Michigan Ave E
Battle Creek, MI 49014-6832
Phone (269) 969-6291

National Provider Directory

National Provider Directory

Locations

1125 Michigan Ave E
Ste 5
Battle Creek, MI 49014
Phone (269) 969-6014

Interoperability endpoints

  • Direct secure messaging: jenniferschaefer@wattlespfp.allscriptsdirect.net
  • Direct secure messaging: markhenry@wattlespfp.allscriptsdirect.net
  • Direct secure messaging: mydhilicheerala@wattlespfp.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 6

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": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1659512705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 MICHIGAN AVE E",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490146832",
            "telephone_number": "269-969-6291",
            "fax_number": "269-969-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MICHIGAN AVE E",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490146832",
            "telephone_number": "269-969-6291",
            "fax_number": "269-969-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATTLES PARK FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "269-969-6291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301083010",
            "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 Jun 9, 2009; 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.