Midmichigan Neuropsychology Associates, P.L.C.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301008040 Issued in MI

Legal business name

MIDMICHIGAN NEUROPSYCHOLOGY ASSOCIATES, P.L.C.

Practice address

4705 Towne Centre Rd.
Suite 304
Saginaw, MI 48604-2821

Phone

(989) 921-5100

Fax

(989) 921-5104

NPI assigned

Feb 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. William D Macinnes, PH.D.

Title

Member

Phone

(989) 921-5100

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1801128657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 TOWNE CENTRE RD.",
            "address_2": "SUITE 304",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042821",
            "telephone_number": "989-921-5100",
            "fax_number": "989-921-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 TOWNE CENTRE RD.",
            "address_2": "SUITE 304",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042821",
            "telephone_number": "989-921-5100",
            "fax_number": "989-921-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDMICHIGAN NEUROPSYCHOLOGY ASSOCIATES, P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "MACINNES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "989-921-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301008040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "WM008040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P93585",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mitsuko Ann Mihan

• Clinical Neuropsychologist in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.