Thunder Bay Clinic Management Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

BB012930 Issued in MI

Legal business name

THUNDER BAY CLINIC MANAGEMENT INC

Practice address

1065 US 23 North
Alpena, MI 49707

Phone

(989) 354-0607

Fax

(989) 356-6710

NPI assigned

Mar 29, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jane E Hardies

Title

Office Manager

Phone

(989) 354-0607

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Bradley Allen Boehm, DO

  • Urology Physician
  • Alpena, MI
  • NPI 1225092554
  Medicare reassignment NPD

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1790746964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 US 23 NORTH",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "49707",
            "telephone_number": "989-354-0607",
            "fax_number": "989-356-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 US 23 NORTH",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "49707",
            "telephone_number": "989-354-0607",
            "fax_number": "989-356-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THUNDER BAY CLINIC MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "HARDIES",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-354-0607",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "MI",
            "license": "BB012930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3438729",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Sue Thomas, LBSW
• Mary Bialas Thompson, CNP
• Hanna Thorn
• Thomas J Thornton, M.D.
• Thunder Bay Chiropractic Center PC
• Thunder Bay Community Health Service, Inc
• Thunder Bay Emergency Physicians PC
• Thunder Bay Eye Care
• Thunder Bay Home Care Services LLC
• Thunder Bay Home Care Services LLC

• Urology Physician in Alpena, MI
• Providers in Alpena, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.