Organization Active NPI

West Michigan Gastroenterology PLC

  • Gastroenterology Physician
  • Muskegon, MI
National Provider Identifier
1679633929
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
WEST MICHIGAN GASTROENTEROLOGY PLC
Practice address
1675 Leahy
Suite 324B
Muskegon, MI 49442-5500
Phone
(231) 726-5075
Fax
(231) 722-1827
NPI assigned
Dec 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Authorized official

Name
Dr. John P Egan Jr., MDNPI 1689665549
Title
Chief Executive Officer
Phone
(231) 726-5075

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
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1675 Leahy
Suite 324B
Muskegon, MI 49442-5500

Mailing address

1675 Leahy
Suite 324B
Muskegon, MI 49442-5500
Phone (231) 726-5075

Other identifiers 1

IdentifierTypeStateIssuer
CM6445OtherMIRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

1675 Leahy St
#342B
Muskegon, MI 49442
Phone (231) 726-5075

1675 Leahy St
Ste 324B
Muskegon, MI 49442
Phone (231) 672-8700

Practitioners & affiliated clinicians

Practitioners 1

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": "1165622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1679633929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY",
            "address_2": "SUITE 324B",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425500",
            "telephone_number": "231-726-5075",
            "fax_number": "231-722-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LEAHY",
            "address_2": "SUITE 324B",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425500",
            "telephone_number": "231-726-5075",
            "fax_number": "231-722-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MICHIGAN GASTROENTEROLOGY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-09",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "231-726-5075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM6445",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.