Organization Active NPI

Michigan Rheumatology Group PC

  • Rheumatology Physician
  • Lapeer, MI
National Provider Identifier
1801968144
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
MICHIGAN RHEUMATOLOGY GROUP PC
Practice address
1254 N Main St
Lapeer, MI 48446-1343
Phone
(810) 667-0067
Fax
(810) 667-0074
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Authorized official

Name
Dr. Barbara A McIntosh Moore, MDNPI 1982652103
Title
MD
Phone
(810) 667-0067

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
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

1254 N Main St
Lapeer, MI 48446-1343

Mailing address

1254 N Main St
Lapeer, MI 48446-1343
Phone (810) 667-4356

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040501000237 MI Part B Supplier - Clinic/Group Practice 5890783773 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Blanc, MI

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1801968144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461343",
            "telephone_number": "810-667-4356",
            "fax_number": "810-667-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461343",
            "telephone_number": "810-667-0067",
            "fax_number": "810-667-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN RHEUMATOLOGY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH MOORE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "810-667-0067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.