NPIMap

Organization Active NPI

Nottawaseppi Huron Band of the Potawatomi

Doing business as NHBP Health Department

  • Federal Public Health Clinic/Center
  • Wyoming, MI
National Provider Identifier
1770500548
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federal Public Health Clinic/CenterTaxonomy code 261QP0904X
License
18732 Issued in MI
Legal business name
NOTTAWASEPPI HURON BAND OF THE POTAWATOMI
Doing business as
NHBP Health Department
Practice address
4415 Byron Center Ave SW
Wyoming, MI 49519-4800
Phone
(616) 249-0159
Fax
(616) 249-8688
NPI assigned
Jul 16, 2006
Last updated
Jul 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Authorized official

Name
Rosalind Johnston
Title
Health Director
Phone
(269) 729-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X 18732 MI Primary

Addresses

Primary practice location

4415 Byron Center Ave SW
Wyoming, MI 49519-4800

Mailing address

1474 Mno - Bmadzewen Way
Fulton, MI 49052-9602
Phone (269) 729-4422

Other names 1

  • NHBP Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008000724 TX Part B Supplier - Clinic/Group Practice 2769441286 Receives reassigned benefits from 15 practitioners
Practice locations: Fulton, MI; Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

1474 Bmadzewen Way
Fulton, MI 49052
Phone (269) 729-4422

311 State St SE
Grand Rapids, MI 49503
Phone (616) 249-0159

2775 W Dickman Rd
Ste L
Springfield, MI 49037
Phone (269) 966-1101

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1770500548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1474 MNO - BMADZEWEN WAY",
            "city": "FULTON",
            "state": "MI",
            "postal_code": "490529602",
            "telephone_number": "269-729-4422",
            "fax_number": "269-729-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194800",
            "telephone_number": "616-249-0159",
            "fax_number": "616-249-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOTTAWASEPPI HURON BAND OF THE POTAWATOMI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "ROSALIND",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "269-729-4422"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "MI",
            "license": "18732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NHBP Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.