NPIMap

Organization Active NPI

Three Rivers Health System, Inc

Doing business as Three Rivers Health IMED

  • Urgent Care Clinic/Center
  • Three Rivers, MI
National Provider Identifier
1821631334
Registry record updated Mar 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
THREE RIVERS HEALTH SYSTEM, INC
Doing business as
Three Rivers Health IMED
Practice address
16587 Enterprise Dr
Three Rivers, MI 49093-7902
Phone
(269) 279-6700
Fax
(269) 279-9612
NPI assigned
Oct 28, 2019
Last updated
Mar 22, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
THREE RIVERS HEALTH SYSTEM, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2026

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

Authorized official

Name
Jeffery Costello
Title
Cfo
Phone
(574) 647-3460

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Urgent Care Clinic/Center 261QU0200X Primary
Occupational Medicine Clinic/Center 261QX0100X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

16587 Enterprise Dr
Three Rivers, MI 49093-7902

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other names 1

  • Three Rivers Health IMED Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140729001948 MI Part B Supplier - Clinic/Group Practice 8729245584 Receives reassigned benefits from 71 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portage, MI; Three Rivers, MI; White Pigeon, MI

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory
Part of
Three Rivers Health System

Locations

16587 Enterprise Dr
Unit 3
Three Rivers, MI 49093
Phone (269) 279-6700

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774137600000",
    "number": "1821631334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16587 ENTERPRISE DR",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490937902",
            "telephone_number": "269-279-6700",
            "fax_number": "269-279-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS HEALTH SYSTEM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THREE RIVERS HEALTH SYSTEM, INC",
        "enumeration_date": "2019-10-28",
        "last_updated": "2026-03-22",
        "certification_date": "2026-03-22",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "574-647-3460"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Health IMED",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Three Rivers Health IMED",
            "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 Mar 22, 2026; 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.