NPIMap

Organization Active NPI

West Michigan ENT PLC

  • Specialist
  • Muskegon, MI
National Provider Identifier
1780883355
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WEST MICHIGAN ENT PLC
Practice address
1365 Mercy Dr
Muskegon, MI 49444-1837
Phone
(231) 739-9095
Fax
(231) 739-6439
NPI assigned
Jul 13, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Raymond Robert Komray, M.D.NPI 1275553513
Title
Physician
Phone
(231) 739-9095

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MI Primary

Addresses

Primary practice location

1365 Mercy Dr
Muskegon, MI 49444-1837

Mailing address

1365 Mercy Dr
Muskegon, MI 49444-1837
Phone (231) 739-9095

Other identifiers 3

IdentifierTypeStateIssuer
1517752MedicaidMI
0406104502OtherMIBLUE CROSS BLUE SHIELD OF
P55690OtherBLUE CARE NETWORK

National Provider Directory

National Provider Directory

Locations

1365 Mercy Dr
Muskegon, MI 49444
Phone (231) 739-5100

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": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1780883355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441837",
            "telephone_number": "231-739-9095",
            "fax_number": "231-739-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441837",
            "telephone_number": "231-739-9095",
            "fax_number": "231-739-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MICHIGAN ENT PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KOMRAY",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "231-739-9095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517752",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "0406104502",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P55690",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.