Dickinson County Healthcare System
Organization Active NPI General Practice Physician · Gladstone, MI
NPI 1821345646 · NPPES record last updated Aug 24, 2012
Key facts
- NPI
- 1821345646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- DICKINSON COUNTY HEALTHCARE SYSTEM
- Practice address
- 2001 Minneapolis Ave
Suite E
Gladstone, MI 49837-2060 - Phone
- (906) 428-2000
- NPI assigned
- Aug 10, 2012
- Organization subpart
- No
Authorized official
- Name
- Alicia Henderson
- Title
- Physician Billing Supervisor
- Phone
- (906) 776-5665
Other NPIs on the same Medicare enrollment 13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050623000153 | MI | Part B Supplier - Clinic/Group Practice | 6800784943 |
Receives reassigned benefits from 13 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Iron Mountain, MI; Norway, MI; Marquette, MI; Kingsford, MI; Ishpeming, MI; Iron River, MI; Bark River, MI |
National Provider Directory
Locations
2001 Minneapolis Ave
Ste E
Gladstone, MI 49837
Phone (906) 428-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | |||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Urology Physician |
208800000X | |||
| General Practice Physician |
208D00000X | Yes | ||
| Podiatrist |
213E00000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
2001 Minneapolis Ave
Suite E
Gladstone, MI 49837-2060
Mailing address
PO Box 549
Iron Mountain, MI 49801-0549
Phone (906) 774-1313
Other names
- Dickinson Medical Services at Bayside Clinic
Other providers in Gladstone, MI
- Brittany Bradway
- Jessica M Cameron
- DB Therapy LLC
- Heather E Demay
- Dickinson County Healthcare System
- DLP Marquette Physician Practices Inc
- Dr. Richard C. Pfotenhauer Family Dentistry
- Fairbanks Family Chiropractic Inc
- David Lee Fairbanks
- Margo Irene Fairbanks
All providers in Gladstone, MI · General Practice Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.