NPIMap

Organization Active NPI

Wattles Park Family Practice II PC

  • Family Medicine Physician
  • Battle Creek, MI
National Provider Identifier
1780072934
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WATTLES PARK FAMILY PRACTICE II PC
Practice address
1125 E Michigan Avenue
Battle Creek, MI 49014
Phone
(269) 969-6014
Fax
(269) 969-6085
NPI assigned
Dec 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Ms. Kendra L Lucas
Title
Office Manager
Phone
(269) 969-6014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1125 E Michigan Avenue
Battle Creek, MI 49014

Mailing address

1125 E Michigan Avenue
Battle Creek, MI 49014
Phone (269) 969-6014

National Provider Directory

National Provider Directory

Locations

1125 Michigan Ave E
Battle Creek, MI 49014
Phone (269) 969-6014

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1780072934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E MICHIGAN AVENUE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49014",
            "telephone_number": "269-969-6014",
            "fax_number": "269-969-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E MICHIGAN AVENUE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49014",
            "telephone_number": "269-969-6014",
            "fax_number": "269-969-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATTLES PARK FAMILY PRACTICE II PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-969-6014",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.