Organization Active NPI

Northern Radiology, PC

  • Diagnostic Radiology Physician
  • Cheboygan, MI
National Provider Identifier
1669487237
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHERN RADIOLOGY, PC
Practice address
748 S Main St
Cheboygan, MI 49721-2220
Phone
(231) 627-1257
Fax
(231) 627-1530
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Michael T Sunday, M.D.NPI 1831154061
Title
Owner/President
Phone
(231) 627-1257

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

748 S Main St
Cheboygan, MI 49721-2220

Mailing address

4420 Varsity Dr
Ann Arbor, MI 48108-2233
Phone (734) 677-7400

Other identifiers 2

IdentifierTypeStateIssuer
300A660020OtherMIBCBS/BCN
CJ7539OtherMIRR MEDICARE

National Provider Directory

National Provider Directory

Locations

4420 Varsity Dr
Ann Arbor, MI 48108

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1669487237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 VARSITY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082233",
            "telephone_number": "734-677-7400",
            "fax_number": "734-677-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-627-1257",
            "fax_number": "231-627-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN RADIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "SUNDAY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "231-627-1257",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/BCN",
            "identifier": "300A660020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CJ7539",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheboygan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.