NPIMap

Organization Active NPI

Michigan Medical PC

  • Vascular Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1700052230
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MICHIGAN MEDICAL PC
Practice address
2093 Health Dr SW
Grand Rapids, MI 49519-9691
Phone
(616) 459-8700
NPI assigned
May 5, 2008
Last updated
May 5, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MICHIGAN MEDICAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Scott Harring
Title
Cfo
Phone
(616) 974-4889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

2093 Health Dr SW
Grand Rapids, MI 49519-9691

Mailing address

4085 Burton St SE
Suite 200
Grand Rapids, MI 49546-2444

National Provider Directory

National Provider Directory
Tax ID family
Michigan Med Spec PC70 organizations share this tax ID, including this one
Part of
Michigan Med Spec PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1700052230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 BURTON ST SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DR SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495199691",
            "telephone_number": "616-459-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN MEDICAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN MEDICAL PC",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "HARRING",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-974-4889"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.