FMG West City Park Drive Michigan LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG WEST CITY PARK DRIVE MICHIGAN LLC

Doing business as

Tendercare Health Center - Munising

Practice address

300 City Park Dr
Munising, MI 49862-1130

Phone

(906) 387-2273

Fax

(906) 387-3922

NPI assigned

Dec 17, 2014

Last updated

Dec 23, 2014By 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

David Keating

Title

Authorized Official

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Tendercare Health Center - Munising Doing business as

Locations

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

{
    "created_epoch": "1418774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1700284148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CITY PARK DR",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621130",
            "telephone_number": "906-387-2273",
            "fax_number": "906-387-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CITY PARK DR",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621130",
            "telephone_number": "906-387-2273",
            "fax_number": "906-387-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG WEST CITY PARK DRIVE MICHIGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-17",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tendercare Health Center - Munising",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hannah M Edmondson, CHW,CPRC,PN
• Bailey Elizabeth Elliott
• Jay H Eppinga, M.D.
• Monica Eriksen
• Patrice Maree Evans, LMSW
• Karen Sue Freeborn, FNP-BC
• Cassandra Gasman
• Marissa Emily Graves, LLMSW
• Great Lakes Recovery Centers
• Paul Walter Haduck, DO

• Skilled Nursing Facility in Munising, MI
• Providers in Munising, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.