Internal Medicine & Aesthetics

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE & AESTHETICS

Practice address

6505 Constitution Blvd
Portage, MI 49024-1604

Phone

(269) 599-8140

Fax

(269) 324-4329

NPI assigned

Mar 11, 2024

Organization subpart

No

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

Authorized official

Name

Julie Bergman

Title

Authorized Official

Phone

(765) 964-4100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Rockelle Donishia Rogers, MD

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1962596502
  Medicare reassignment NPD

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1780442103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 443",
            "city": "UNION CITY",
            "state": "IN",
            "postal_code": "473900443",
            "telephone_number": "765-964-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 CONSTITUTION BLVD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490241604",
            "telephone_number": "269-599-8140",
            "fax_number": "269-324-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE & AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "765-964-4100"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Manners Immink, PA
• Infinity Non Emergency Medical Transportation LLC
• Nicholis Ingle, BCBA
• Inner Garden Counseling, PLLC
• Intentional Journey Counseling Services, PLLC
• Internal Medicine and Vitality, PLLC
• Pedro Irizarry Plaza
• Laura Isaacs
• Jayden Iskra
• Ismail B. Sendi, MD PC

• Internal Medicine Physician in Portage, MI
• Providers in Portage, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.