NPIMap

Organization Active NPI

DLP Marquette Physician Practices Inc

Doing business as Marquette Medical Clinic - Iron River

  • Family Medicine Physician
  • Iron River, MI
National Provider Identifier
1790033207
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DLP MARQUETTE PHYSICIAN PRACTICES INC
Doing business as
Marquette Medical Clinic - Iron River
Practice address
1500 W Ice Lake Rd
Iron River, MI 49935-8509
Phone
(906) 265-5378
Fax
(906) 265-6332
NPI assigned
Aug 15, 2012
Last updated
Aug 15, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
DLP MARQUETTE PHYSICIAN PRACTICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Authorized official

Name
Jess N Judy
Title
President
Phone
(615) 372-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1500 W Ice Lake Rd
Iron River, MI 49935-8509

Mailing address

1500 W Ice Lake Rd
Iron River, MI 49935-8509
Phone (906) 265-5378

Other names 1

  • MARQUETTE MEDICAL CLINIC - IRON RIVER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121016000312 MI Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 467 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marquette, MI; Negaunee, MI; Newberry, MI; Escanaba, MI; Ontonagon, MI; Sault Sainte Marie, MI; Ternary, MI; Manistique, MI…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory
Part of
DLP Marquette Physician Inc

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1790033207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W ICE LAKE RD",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "499358509",
            "telephone_number": "906-265-5378",
            "fax_number": "906-265-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W ICE LAKE RD",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "499358509",
            "telephone_number": "906-265-5378",
            "fax_number": "906-265-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP MARQUETTE PHYSICIAN PRACTICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DLP MARQUETTE PHYSICIAN PRACTICES INC",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARQUETTE MEDICAL CLINIC - IRON RIVER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iron River, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.