Mackinaw Trail Health Associates, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MACKINAW TRAIL HEALTH ASSOCIATES, P.C.

Practice address

7917 Mackinaw TRL
Cadillac, MI 49601-9746

Phone

(231) 779-9700

Fax

(231) 779-9765

NPI assigned

Nov 29, 2006

Last updated

May 26, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerald Herring, M.D.NPI 1750348975

Title

President

Phone

(231) 779-9700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 4

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.

• Cecilia Dietrich, MD

  • Pediatrics Physician
  • Grand Rapids, MI
  • NPI 1992158851
  Medicare reassignment NPD
• Gerald Herring, M.D.

  • Pediatrics Physician
  • Cadillac, MI
  • NPI 1750348975
  Authorized official Same address or phone
• Susan Betts-Barbus, M.D.

  • Pediatrics Physician
  • Cadillac, MI
  • NPI 1437116233
  NPD
• Elizabeth Whitney Rzepkaalto, MD

  • Pediatrics Physician
  • Cadillac, MI
  • NPI 1033176599
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1669549333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 963",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496010963",
            "telephone_number": "231-775-6076",
            "fax_number": "231-775-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7917 MACKINAW TRL",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496019746",
            "telephone_number": "231-779-9700",
            "fax_number": "231-779-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKINAW TRAIL HEALTH ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "HERRING",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-779-9700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mairi Lyon
• Lizbeth Gabel Maccord, RN
• Kristina Lee Maceachern
• Scott Machin, LMSW
• Mackinaw Trail Health Associates P C
• Jacob Ian Maclean, DO
• Amanda Marie Maga, LLMSW
• Niladri Mal, M.D.
• Maple Ridge Living Center of Cadillac LLC
• Tekoa Marshall

• Pediatrics Physician in Cadillac, MI
• Providers in Cadillac, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.