NPIMap

Organization Active NPI

Three Rivers Health

Doing business as Three Rivers Health Pediatrics

  • Pediatrics Physician
  • Three Rivers, MI
National Provider Identifier
1801871405
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
750020 Issued in MI
Legal business name
THREE RIVERS HEALTH
Doing business as
Three Rivers Health Pediatrics
Practice address
711 S Health Pkwy
Suite 1
Three Rivers, MI 49093-9387
Phone
(269) 273-5005
Fax
(269) 273-9749
NPI assigned
Dec 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Matt Chambers
Title
Chief Executive Officer
Phone
(269) 278-1145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 750020 MI Primary

Addresses

Primary practice location

711 S Health Pkwy
Suite 1
Three Rivers, MI 49093-9387

Mailing address

711 S Health Pkwy
Suite L-7
Three Rivers, MI 49093-9387
Phone (269) 273-9723

Other names 1

  • Three Rivers Health Pediatrics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801871405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S HEALTH PKWY",
            "address_2": "SUITE L-7",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490939387",
            "telephone_number": "269-273-9723",
            "fax_number": "269-273-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S HEALTH PKWY",
            "address_2": "SUITE 1",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490939387",
            "telephone_number": "269-273-5005",
            "fax_number": "269-273-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "269-278-1145"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "750020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Health Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.