Organization Active NPI

Integrative Specialty Care of Northern Michigan

  • Internal Medicine Physician
  • Petoskey, MI
National Provider Identifier
1750744066
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301041105 Issued in MI
Legal business name
INTEGRATIVE SPECIALTY CARE OF NORTHERN MICHIGAN
Practice address
3250 Woods Way
Petoskey, MI 49770-7628
Phone
(231) 348-3800
Fax
(877) 397-7480
NPI assigned
Apr 4, 2016
Last updated
Apr 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Authorized official

Name
Irene Kazmers, MDNPI 1437113032
Title
Co-Owner
Phone
(231) 348-3800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4301041105 MI Primary
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X 4301041105 MI
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X 4301041254 MI
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X 4301041254 MI

Addresses

Primary practice location

3250 Woods Way
Petoskey, MI 49770-7628

Mailing address

3250 Woods Way
Petoskey, MI 49770-7628
Phone (231) 348-3800

National Provider Directory

National Provider Directory

Locations

3250 Woods Way
Petoskey, MI 49770
Phone (231) 348-3800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1750744066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 WOODS WAY",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497707628",
            "telephone_number": "231-348-3800",
            "fax_number": "877-397-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WOODS WAY",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497707628",
            "telephone_number": "231-348-3800",
            "fax_number": "877-397-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE SPECIALTY CARE OF NORTHERN MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "KAZMERS",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "231-348-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041105",
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MI",
            "license": "4301041105",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MI",
            "license": "4301041254",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301041254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.