South County ENT

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301074195 Issued in MI

Legal business name

SOUTH COUNTY ENT

Practice address

60 N Saint Joseph Ave
Suite C
Niles, MI 49120-2296

Phone

(269) 687-2910

Fax

(269) 687-8770

NPI assigned

Feb 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Mary Geegan Middleton

Title

Executive Director

Phone

(269) 684-0259

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1740252535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N SAINT JOSEPH AVE",
            "address_2": "SUITE C",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202296",
            "telephone_number": "269-687-2910",
            "fax_number": "269-687-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 N SAINT JOSEPH AVE",
            "address_2": "SUITE C",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202296",
            "telephone_number": "269-687-2910",
            "fax_number": "269-687-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY ENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "GEEGAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "269-684-0259",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301074195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA1319",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Niles, MI
• Providers in Niles, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.