NPIMap

Organization Active NPI

Portage Physician Practices Inc.

  • Family Medicine Physician
  • Houghton, MI
National Provider Identifier
1679902191
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PORTAGE PHYSICIAN PRACTICES INC.
Practice address
921 W Sharon Ave
Houghton, MI 49931-1921
Phone
(906) 483-1777
Fax
(906) 483-4616
NPI assigned
Nov 5, 2013
Organization subpart
Yes
Parent organization
PORTAGE PHYSICIAN PRACTICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Monica Bowman
Title
President
Phone
(615) 920-7000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

921 W Sharon Ave
Houghton, MI 49931-1921

Mailing address

921 W Sharon Ave
Houghton, MI 49931-1921
Phone (906) 483-1777

Other names 1

  • PORTAGE HEALTH EXPRESS CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131210001058 MI Part B Supplier - Clinic/Group Practice 6103053509 Receives reassigned benefits from 150 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Calumet, MI; Hancock, MI; Houghton, MI; Lake Linden, MI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Portage Physician Practices Inc

Practitioners & affiliated clinicians

Practitioners 7

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": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1679902191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W SHARON AVE",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311921",
            "telephone_number": "906-483-1777",
            "fax_number": "906-483-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W SHARON AVE",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311921",
            "telephone_number": "906-483-1777",
            "fax_number": "906-483-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PHYSICIAN PRACTICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTAGE PHYSICIAN PRACTICES INC.",
        "enumeration_date": "2013-11-05",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PORTAGE HEALTH EXPRESS CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PORTAGE HEALTH EXPRESS CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houghton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.