NPIMap

Organization Active NPI

McLaren Port Huron

  • Certified Registered Nurse Anesthetist
  • Port Huron, MI
National Provider Identifier
1669624318
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MCLAREN PORT HURON
Practice address
1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone
(810) 987-5000
NPI assigned
Oct 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Bridget Sholtis
Title
VP/Cfo
Phone
(810) 989-3749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1221 Pine Grove Ave
Port Huron, MI 48060-3511

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

National Provider Directory

National Provider Directory
Tax ID family
Port Huron Hospita2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1669624318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-987-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN PORT HURON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "SHOLTIS",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "810-989-3749"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.