Organization Active NPI

Northern Family Medicine, PLLC

  • Family Medicine Physician
  • Petoskey, MI
National Provider Identifier
1801364005
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHERN FAMILY MEDICINE, PLLC
Practice address
3890 Charlevoix Rd Ste 230
Petoskey, MI 49770-8420
Phone
(123) 134-7190
NPI assigned
Nov 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Authorized official

Name
Dr. Janet Talmo, M DNPI 1932152071
Title
Owner
Phone
(231) 347-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3890 Charlevoix Rd Ste 230
Petoskey, MI 49770-8420

Mailing address

2810 Charlevoix Rd Ste 104
Petoskey, MI 49770-8421
Phone (231) 347-1900

Other identifiers 1

IdentifierTypeStateIssuer
4301049260OtherMISTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181221000086 MI Part B Supplier - Clinic/Group Practice 9739424631 Receives reassigned benefits from 1 practitioner
Practice locations: Petoskey, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2323876Northern Family Medicine3890 Charlevoix Avenue Suite 230, Petoskey, MI 49770Certificate of waiverMay 13, 2027

National Provider Directory

National Provider Directory

Locations

3890 Charlevoix Rd
Ste 230
Petoskey, MI 49770
Phone (231) 347-1900

3890 Charlevoix Rd
Ste 0
Petoskey, MI 49770

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1801364005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 CHARLEVOIX RD STE 104",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708421",
            "telephone_number": "231-347-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 CHARLEVOIX RD STE 230",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708420",
            "telephone_number": "123-134-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "TALMO",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-347-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301049260",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.